Uncertain Times

by Hammer, Peter J.; Haas-Wilson, Deborah; Peterson, Mark A.; Sage, William M.

• ISBN13: 9780822332091
• ISBN10: 0822332094
• Format: Hardcover
• Copyright: 2004-01-01
• Publisher: Duke Univ Pr

Summary

This volume revisits the Nobel Prize-winning economist Kenneth Arrowrs"s classic 1963 essay "Uncertainty and the Welfare Economics of Medical Care" in light of the many changes in American health care since its publication. Arrowrs"s groundbreaking piece, reprinted in full here, argued that while medicine was subject to the same models of competition and profit maximization as other industries, concepts of trust and morals also played key roles in understanding medicine as an economic institution and in balancing the asymmetrical relationship between medical providers and their patients. His conclusions about the medical professionrs"s failures to "insure against uncertainties" helped initiate the reevaluation of insurance as a public and private good.Coming from diverse backgrounds-economics, law, political science, and the health care industry itself-the contributors use Arrowrs"s article to address a range of present-day health-policy questions. They examine everything from health insurance and technological innovation to the roles of charity, nonprofit institutions, and self-regulation in addressing medical needs. The collection concludes with a new essay by Arrow, in which he reflects on the health care markets of the new millennium. At a time when medical costs continue to rise, the ranks of the uninsured grow, and uncertainty reigns even among those with health insurance, this volume looks back at a seminal work of scholarship to provide critical guidance for the years ahead.Contributors Linda H. Aiken Kenneth J. Arrow Gloria J. Bazzoli M. Gregg Bloche Lawrence Casalino Michael Chernew Richard A. Cooper Victor R. Fuchs Annetine C. Gelijns Sherry A. Glied Deborah Haas-Wilson Mark A. Hall Peter J. Hammer Clark C. Havighurst Peter D. Jacobson Richard Kronick Michael L. Millenson Jack Needleman Richard R. Nelson Mark V. Pauly Mark A. Peterson Uwe E. Reinhardt James C. Robinson William M. Sage J. B. Silvers Frank A. Sloan Joshua Graff Zivin

Table of Contents

Foreword
Mark V. Pauly	vii
Preface
Victor R. Fuchs	xiii
Kenneth Arrow and the Changing Economics of Health Care: "Why Arrow? Why Now?"
Peter J. Hammer, Deborah Haas-Wilson, Mark A. Peterson, and William M. Sage	xvii
Uncertainty and the Welfare Economics of Medical Care (American Economic Review, 1963)
Kenneth J. Arrow	1	(36)
PART I: SUPPLY, DEMAND, AND HEALTH CARE COMPETITION
General Equilibrium and Marketability in the Health Care Industry
Michael Chernew	37	(12)
Arrow's Concept of the Health Care Consumer: A Forty-Year Retrospective
Frank A. Sloan	49	(11)
Uncertainty and Technological Change in Medicine
Annetine C. Gelijns, Joshua Graff Zivin, and Richard R. Nelson	60	(11)
Human Inputs: The Health Care Workforce and Medical Markets
Richard A. Cooper and Linda H. Aiken	71	(13)
Health Care as a (Big) Business: The Antitrust Response
Clark C. Havighurst	84	(19)
PART 2: RISK, INSURANCE, AND REDISTRIBUTION
Health Insurance and Market Failure since Arrow
Sherry A. Glied	103	(8)
Can Efficiency in Health Care Be Left to the Market?
Uwe E. Reinhardt	111	(23)
Valuing Charity
Richard Kronick	134	(8)
Medical Service Risk and the Evolution of Provider Compensation Arrangements
Gloria J. Bazzoli	142	(14)
The Role of the Capital Markets in Restructuring Health Care
J.B. Silvers	156	(13)
PART 3: INFORMATION, KNOWLEDGE, AND MEDICAL MARKETS
Arrow and the Information Market Failure in Health Care: The Changing Content and Sources of Health Care Information
Deborah Haas-Wilson	169	(12)
The End of Asymmetric Information
James C. Robinson	181	(8)
Managing Uncertainty: Intermediate Organizations as Triple Agents
Lawrence Casalino	189	(13)
Moral Hazard vs. Real Hazard: Quality of Care Post-Arrow
Michael L. Millenson	202	(13)
PART 4: SOCIAL NORMS AND PROFESSIONALISM
Arrow's Analysis of Social Institutions: Entering the Marketplace with Giving Hands?
Peter J. Hammer	215	(15)
The Market for Medical Ethics
M. Gregg Bloche	230	(13)
The Role of Nonprofits in Health Care
Jack Needleman	243	(16)
Arrow on Trust
Mark A. Hall	259	(13)
From Trust to Political Power: Interest Groups, Public Choice, and Health Care
Mark A. Peterson	272	(18)
Regulating Health Care: From Self Regulation to Self Regulation?
Peter D. Jacobson	290	(12)
The Lawyerization of Medicine
William M. Sage	302	(19)
PART 5: RESPONSE BY PROFESSOR ARROW
Reflections on the Reflections
Kenneth J. Arrow	321	(6)
Contributors	327	(8)
Index	335