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  • 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 Economics Review, 1963) / Kenneth J. Arrow 1

    Part 1: Supply, Demand, and Health Care Competition

    General Equilibrium and Marketability in the Health Care Industry / Michael Chernew 37

    Arrow's Concept of the Health Care Consumer: A Forty-Year Retrospective / Frank A. Sloan 49

    Uncertainty and Technological Change in Medicine / Annetine G. Gelijns, Joshua Graff Zivin, and Richard R. Nelson 60

    Human Inputs: The Health Care Workforce and Medical Markets / Richard A. Cooper and Linda H. Aiken 71

    Health Care as a (Big) Business: The Antitrust Response / Clark C. Havighurst 84

    Part 2: Risk, Insurance, and Redistribution

    Health Insurance and Market Failure since Arrow / Sherry A. Glied 103

    Can Efficiency in Health Care Be Left to the Market? / Uwe E. Reinhardt 111

    Valuing Charity / Richard Kronick 134

    Medical Service Risk and the Evolution of Provider Compensation Arrangements / Gloria J. Bazzoli 142

    The Role of the Capital Markets in Restructuring Health Care / J. B. Silvers 156

    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

    The End of Asymmetric Information / James C. Robinson 181

    Managing Uncertainty: Intermediate Organizations as Triple Agents / Lawrence Casalino 189

    Moral Hazard vs. Real Hazard: Quality of Care Post-Arrow / Michael L. Millenson 202

    Part 4: Social Norms and Professionalism

    Arrow's Analysis of Social Institutions: Entering the Marketplace with Giving Hands? / Peter J. Hammer 215

    The Market for Medical Ethics / M. Gregg Bloche 230

    The Role of Nonprofits in Health Care / Jack Needleman 243

    Arrow on Trust / Mark A. Hall 259

    From Trust to Political Power: Interest Groups, Public Choice, and Health Care / Mark A. Peterson 272

    Regulating Health Care: From Self-Regulation to Self-Regulation? / Peter D. Jacobson 290

    The Lawyerization of Medicine / William M. Sage 302

    Part 5: Response by Professor Arrow

    Reflections on Reflections / Kenneth J. Arrow 321

    Contributors 327

    Index 335
  • Mark V. Pauly

    Victor R. Fuchs

    Peter J. Hammer

    Kenneth J. Arrow

    Michael Chernew

    Frank A. Sloan

    Annetine C. Gelijns

    Richard A. Cooper

    Clark C. Havighurst

    Sherry Glied

    Uwe E. Reinhardt

    Richard Kronick

    Gloria Bazzoli

    J.B. Silvers

    James C. Robinson

    Lawrence P. Casalino

    Michael L. Millenson

    M. Gregg Bloche

    Jack Needleman

    Mark A. Hall

    Peter D. Jacobson

    Deborah Haas-Wilson

    Mark A. Peterson

    William M. Sage

    Joshua Graff Zivin

    Richard R. Nelson

    LInda Aiken

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  • Description

    This volume revisits the Nobel Prize-winning economist Kenneth Arrow’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. Arrow’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 profession’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 Arrow’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

    About The Author(s)

    Peter J. Hammer is Assistant Professor at the University of Michigan Law School.

    Deborah Haas-Wilson is Professor of Economics at Smith College.

    Mark A. Peterson is Professor of Policy Studies and Political Science at the University of California, Los Angeles, School of Public Policy and Social Research.

    William M. Sage is Professor at the Columbia University School of Law.

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