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Hardcover | Out of Print | 192 pp. | 6 x 9 in | February 2010 | ISBN: 9780262014076
Paperback | $3.75 Short | £3.95 | 192 pp. | 6 x 9 in | February 2012 | ISBN: 9780262517256
eBook | $15.95 Short | February 2012 | ISBN: 9780262266321
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Health Care Turning Point

Why Single Payer Won't Work


In the battle over health care reform we can try to fashion new policies based on old ideas--or we can acknowledge today’s demographic and economic realities. In Health Care Turning Point, health policy expert Roger Battistella argues that the conventional wisdom that dominates health policy debates is out of date. Battistella takes on popular misconceptions about the advantages of single-payer plans, the role of the market, and other health policy issues and outlines a pragmatic new approach.

Few would disagree that the current system is broken. But, Battistella asserts provocatively, a government takeover of health insurance patterned after Medicare and Medicaid won’t work either. Battistella argues that contrary to popular belief, single-payer coverage will not lower health spending but would encourage overconsumption and drive costs up. If consumers were responsible for buying their own health insurance (as they are for buying their own car and home insurance), he argues, they’d look for value and demand greater price and quality transparency from providers.

The economic shibboleth that the principles of market competition don’t apply to health care is nonsense, Battistella says. We won’t achieve real health care reform until policy makers adjust to this reality and adopt a more pragmatic view.

About the Author

Roger M. Battistella is Emeritus Professor of Health Policy and Management in the Sloan Graduate Program in Health Administration at Cornell University.

Table of Contents

  • Health Care Turning Point
  • Health Care Turning Point
  • Why Single Payer Won’t Work
  • Roger M. Battistella
  • The MIT Press
  • Cambridge, Mass.
  • London, England
  • ©
  • 2010
  • Massachusetts Institute of Technology
  • All rights reserved. No part of this book may be reproduced in any form by any electronic or mechanical means (including photocopying, recording, or information storage and retrieval) without permission in writing from the publisher.
  • For information about special quantity discounts, please email special_sales@mitpress
  • This book was set in Palatino by Graphic Composition, Inc. Printed and bound in the United States of America.
  • Library of Congress ­Cataloging-­in-Publication Data
  • Battistella, Roger M.
  • Health care turning point : why single payer won’t work / Roger M. Battistella.
  •  p. ; cm.
  • Includes bibliographical references and index.
  • ISBN 978-0-262-01407-6 (hardcover : alk. paper)
  • 1. Medical policy—United States. 2. Health care reform—United States. I. Title.
  • [DNLM: 1. Health Care ­Reform—United States. WA 540 AA1 B336h 2010]
  • RA395.A3B285 2010
  • 362.1’0425—dc22
  • 2009033439
  • 10 9 8 7 6 5 4 3 2 1
  • The men of any generation are like dwarfs seated on the shoulders of giants. If we are to see more things than the ancients and things more distant, it is due neither to the sharpness of our sights nor the greatness of our stature but simply because they have lent us their own.
  • —Bernard of Chartres
  • To my mother who sacrificed for a dream—
I hope I have made her proud.
  • Contents
  • Acknowledgments xi
  • Introduction xiii
  • 1 Health Policy: Then and Now 1
  • 2 Resistance to Change 19
  • 3 Contemporary Challenges 37
  • 4 Contemporary Realities 59
  • 5 Popular Misconceptions 77
  • 6 Health Policy Reconfigured 109
  • References 135
  • Index 153


““Battistella advocates practicality and pragmatism as an alternative to ideological panaceas—a timely reminder and important reading as the country struggles through its latest attempts at health care reform.”--Gail Wilensky, Project Hope”