Making (Some) Sense of the Health Care Reform Debate: Social Science, Social Insurance, Social-'Ism,' and So On
53 Challenge 28 (2010)
26 Pages Posted: 8 Oct 2009 Last revised: 3 Apr 2013
Date Written: October 7, 2009
It has been bemusing to behold how ill-informed, mis-informed, and even dis-informed much of the current debate over health care reform has been these past several months. Some of the trouble surely has stemmed from bad faith on the part of some protagonists. Another part of the trouble has stemmed from ineffective communication on the part of other protagonists. Much of our trouble, however, might stem from less than full clarity on all of our parts about two facts. The first is that in talking about “health care reform” as a public policy issue, we are actually talking about social insurance reform. The second is that in talking about social insurance reform, we implicate a well developed discipline familiar both to the social sciences and to the financial services industry – the theory and practice of insurance. Careful attention paid the basic structural features of insurance – how it works, the kinds of market failure to which it is prone, and the ways in which health insurance in particular both implicates and intensifies those vulnerabilities – will render clearer what is at stake in the current debate, and enable us better to assess the competing proposals before us.
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