Saturday, February 17, 2007

Why Change is Difficult

Great sentences and great writers assemble the pieces of ideas we all have floating around in our brains and put them together in a way that clicks.

Take for example this gem from page C3 of Thursday's New York Times. It comes from an article by Robert H. Frank, economist at Cornell University, explaining why it's difficult to implement a single payer health insurance system even though it would dramatically reduce overall health care costs. He writes:
"Those who stand to lose from policy changes always battle harder than those who stand to gain -- an asymmetry that is exaggerated when losses would be concentrated and gains diffuse."
46 million Americans who currently don't have health insurance would benefit from a new single payer health insurance system. What's that worth to the average person--$4,000? $5,000? Maybe even $10,000 a year? However, the current health insurance industry (which consumes an obscene 31 cents of every health care dollar spent in the United States) would be decimated by a move to a single payer health plan.

Dr. Frank's point is that the insurance executive who earns $15 million dollar a year (and his $750,000 a year VPs and all his $85,000 a year staff) will battle harder (to prevent needed reform) than those who support reform and stand to gain $5,000 to $10,000 a year in reduced health insurance costs. The losses are concentrated and the gains are diffuse which impacts how aggressively people play the policy game.

I think it explains why a lot of obviously needed reform (regulating carbon emissions, regulating nicotine, regulating the meatpacking and produce industries) often languishes in Congress in spite of overwhelming popular support.

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