Question A:
Replacing the current US health insurance system (including employer-based health insurance, ACA exchange policies, and Medicaid) with universal ‘Medicare for All’ (mandatory enrollment in a modified version of the existing traditional Medicare program with drug coverage and no cost-sharing of any form, and current Medicare reimbursement rates) funded by federal taxes would lead to lower aggregate medical debt among patients.
Responses
Responses weighted by each expert's confidence
Question B:
Replacing the current US health insurance system as outlined in a) would lead to lower aggregate innovation in the pharmaceutical industry.
Responses
Responses weighted by each expert's confidence
Question C:
Replacing the current US health insurance system as outlined in a) would improve health outcomes for the majority of the population.
Responses
Responses weighted by each expert's confidence
Question A Participant Responses
| Participant | University | Vote | Confidence | Bio/Vote History |
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 Daron Acemoglu |
MIT | Bio/Vote History | ||
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But it would probably lead to higher aggregate spending unless various measures are simultaneously taken. Transition would be very difficult
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 Alberto Alesina |
Harvard | Did Not Answer | Bio/Vote History | |
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 Joseph Altonji |
Yale | Bio/Vote History | ||
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 Alan Auerbach |
Berkeley | Bio/Vote History | ||
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 David Autor |
MIT | Bio/Vote History | ||
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 Katherine Baicker |
University of Chicago | Bio/Vote History | ||
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 Abhijit Banerjee |
MIT | Did Not Answer | Bio/Vote History | |
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 Marianne Bertrand |
Chicago | Bio/Vote History | ||
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 Markus Brunnermeier |
Princeton | Bio/Vote History | ||
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 Raj Chetty |
Harvard | Did Not Answer | Bio/Vote History | |
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 Judith Chevalier |
Yale | Bio/Vote History | ||
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I am not sure that anyone is really realistically talking about no cost sharing of any form.
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 David Cutler |
Harvard | Bio/Vote History | ||
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 Angus Deaton |
Princeton | Bio/Vote History | ||
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Unless you are counting the federal deficit?
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 Darrell Duffie |
Stanford | Bio/Vote History | ||
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"Funded by federal taxes" implies a large increase in federal debt borne by everyone, so the question is not very probative of debt effects.
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 Aaron Edlin |
Berkeley | Bio/Vote History | ||
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 Barry Eichengreen |
Berkeley | Bio/Vote History | ||
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Medical debt? Strange formulation. But experience of other countries is that universal coverage can reduce health care expenditure/GDP.
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 Liran Einav |
Stanford | Bio/Vote History | ||
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 Ray Fair |
Yale | Bio/Vote History | ||
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 Amy Finkelstein |
MIT | Bio/Vote History | ||
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 Austan Goolsbee |
Chicago | Did Not Answer | Bio/Vote History | |
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 Michael Greenstone |
University of Chicago | Bio/Vote History | ||
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 Robert Hall |
Stanford | Bio/Vote History | ||
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Medical debt is a complicated issue and I lack the professional background to have an opinion
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 Oliver Hart |
Harvard | Bio/Vote History | ||
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 Bengt Holmström |
MIT | Bio/Vote History | ||
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 Caroline Hoxby |
Stanford | Bio/Vote History | ||
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Unless I misunderstand the question, the answer seems obvious. However, total debt (including govt) could easily rise.
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 Hilary Hoynes |
Berkeley | Bio/Vote History | ||
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 Kenneth Judd |
Stanford | Bio/Vote History | ||
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 Steven Kaplan |
Chicago Booth | Bio/Vote History | ||
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Depends on costs and what the costs do to Federal debt and taxes.
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 Anil Kashyap |
Chicago Booth | Bio/Vote History | ||
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 Pete Klenow |
Stanford | Bio/Vote History | ||
 Jonathan Levin |
Stanford | Bio/Vote History | ||
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Yes, we’d pay health care costs in taxes and federal borrowing instead.
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 Eric Maskin |
Harvard | Bio/Vote History | ||
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 William Nordhaus |
Yale | Bio/Vote History | ||
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 Maurice Obstfeld |
Berkeley | Bio/Vote History | ||
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 Emmanuel Saez |
Berkeley | Bio/Vote History | ||
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 Larry Samuelson |
Yale | Bio/Vote History | ||
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Patients not incur less debt, but increased resources must be devoted to health care, and funded.
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 José Scheinkman |
Columbia University | Bio/Vote History | ||
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 Richard Schmalensee |
MIT | Bio/Vote History | ||
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The large shocks that seem to drive medical debt would be eliminated.
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 Carl Shapiro |
Berkeley | Bio/Vote History | ||
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 Robert Shimer |
University of Chicago | Bio/Vote History | ||
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Lower medical debt but higher taxes
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 James Stock |
Harvard | Bio/Vote History | ||
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 Richard Thaler |
Chicago Booth | Bio/Vote History | ||
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 Christopher Udry |
Northwestern | Bio/Vote History | ||
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At least some of what is currently labeled medical debt would be transformed into other more broadly shared forms of debt.
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Question B Participant Responses
| Participant | University | Vote | Confidence | Bio/Vote History |
|---|---|---|---|---|
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Daron Acemoglu |
MIT | Bio/Vote History | ||
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Question is whether most of the lost innovation is high social value. It may be some of the "me too" drugs and costly techs that go down.
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Alberto Alesina |
Harvard | Did Not Answer | Bio/Vote History | |
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Joseph Altonji |
Yale | Bio/Vote History | ||
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Alan Auerbach |
Berkeley | Bio/Vote History | ||
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David Autor |
MIT | Bio/Vote History | ||
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Katherine Baicker |
University of Chicago | Bio/Vote History | ||
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Abhijit Banerjee |
MIT | Did Not Answer | Bio/Vote History | |
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Marianne Bertrand |
Chicago | Bio/Vote History | ||
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Markus Brunnermeier |
Princeton | Bio/Vote History | ||
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Raj Chetty |
Harvard | Did Not Answer | Bio/Vote History | |
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Judith Chevalier |
Yale | Bio/Vote History | ||
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An extension of something like Medicare Part D--- I don't think it is clear what impact that would have.
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David Cutler |
Harvard | Bio/Vote History | ||
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Angus Deaton |
Princeton | Bio/Vote History | ||
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And a good thing too!
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Darrell Duffie |
Stanford | Bio/Vote History | ||
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Research regarding the impact of competitive pressures on innovation has mixed results.
-see background information here |
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Aaron Edlin |
Berkeley | Bio/Vote History | ||
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Medicare is likely to pay less for drugs leading to less innovation.
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Barry Eichengreen |
Berkeley | Bio/Vote History | ||
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Liran Einav |
Stanford | Bio/Vote History | ||
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Ray Fair |
Yale | Bio/Vote History | ||
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Amy Finkelstein |
MIT | Bio/Vote History | ||
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Austan Goolsbee |
Chicago | Did Not Answer | Bio/Vote History | |
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Michael Greenstone |
University of Chicago | Bio/Vote History | ||
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i'm unaware of evidence that would allow for confidence that it would increase or decrease pharma innovation
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Robert Hall |
Stanford | Bio/Vote History | ||
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The specification of the policy change said nothing about what prices the gov would pay for drugs, so this is a an unanswerable question.
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Oliver Hart |
Harvard | Bio/Vote History | ||
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Bengt Holmström |
MIT | Bio/Vote History | ||
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Caroline Hoxby |
Stanford | Bio/Vote History | ||
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Arguments & evidence on both sides. Nothing like the experiment, w/all g.e. effects, has been tried. (US role differs from other nations'.)
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Hilary Hoynes |
Berkeley | Bio/Vote History | ||
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Kenneth Judd |
Stanford | Bio/Vote History | ||
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The rate of innovation is determined by many factors unrelated to profits. The policy in a) certainly would not help.
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Steven Kaplan |
Chicago Booth | Bio/Vote History | ||
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Depends on how government negotiates with and funds pharma.
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Anil Kashyap |
Chicago Booth | Bio/Vote History | ||
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reducing the returns is likely to lower investment
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Pete Klenow |
Stanford | Bio/Vote History | ||
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Jonathan Levin |
Stanford | Bio/Vote History | ||
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Quite possible but hard to say because it depends on federal funding of science and rewards for discovery.
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Eric Maskin |
Harvard | Bio/Vote History | ||
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William Nordhaus |
Yale | Bio/Vote History | ||
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Maurice Obstfeld |
Berkeley | Bio/Vote History | ||
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Emmanuel Saez |
Berkeley | Bio/Vote History | ||
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Larry Samuelson |
Yale | Bio/Vote History | ||
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The effect on innovation will depend on how the pharma industry is compensated; design elements that go beyond current medicare rates.
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José Scheinkman |
Columbia University | Bio/Vote History | ||
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Richard Schmalensee |
MIT | Bio/Vote History | ||
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Demand would go up, and prices would remain unregulated by assumption.
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Carl Shapiro |
Berkeley | Bio/Vote History | ||
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Robert Shimer |
University of Chicago | Bio/Vote History | ||
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Depends on drug prices
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James Stock |
Harvard | Bio/Vote History | ||
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Richard Thaler |
Chicago Booth | Bio/Vote History | ||
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Christopher Udry |
Northwestern | Bio/Vote History | ||
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And probably change the type of innovation
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Question C Participant Responses
| Participant | University | Vote | Confidence | Bio/Vote History |
|---|---|---|---|---|
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Daron Acemoglu |
MIT | Bio/Vote History | ||
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Alberto Alesina |
Harvard | Did Not Answer | Bio/Vote History | |
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Joseph Altonji |
Yale | Bio/Vote History | ||
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Alan Auerbach |
Berkeley | Bio/Vote History | ||
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David Autor |
MIT | Bio/Vote History | ||
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Probably yes on average because it would pull up lower tail. But not for the majority who are already insured.
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Katherine Baicker |
University of Chicago | Bio/Vote History | ||
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Abhijit Banerjee |
MIT | Did Not Answer | Bio/Vote History | |
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Marianne Bertrand |
Chicago | Bio/Vote History | ||
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Markus Brunnermeier |
Princeton | Bio/Vote History | ||
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Raj Chetty |
Harvard | Did Not Answer | Bio/Vote History | |
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Judith Chevalier |
Yale | Bio/Vote History | ||
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Likely would for those who are currently uninsured.
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David Cutler |
Harvard | Bio/Vote History | ||
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Angus Deaton |
Princeton | Bio/Vote History | ||
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Look at the data for any other country
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Darrell Duffie |
Stanford | Bio/Vote History | ||
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With so many people who can't afford healthcare now, healthcare for all would likely have this effect, albeit at a high cost to taxpayers.
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Aaron Edlin |
Berkeley | Bio/Vote History | ||
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Probably better for some and worse for others. On balance hard to know.
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Barry Eichengreen |
Berkeley | Bio/Vote History | ||
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Precise result depends on extent and incidence of rationing of care. (Hence the low level of confidence.)
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Liran Einav |
Stanford | Bio/Vote History | ||
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Ray Fair |
Yale | Bio/Vote History | ||
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Amy Finkelstein |
MIT | Bio/Vote History | ||
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Austan Goolsbee |
Chicago | Did Not Answer | Bio/Vote History | |
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Michael Greenstone |
University of Chicago | Bio/Vote History | ||
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Robert Hall |
Stanford | Bio/Vote History | ||
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It would probably be an improvement for a segment of the population, but I don't have the expertise to determine if it would be a majority.
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Oliver Hart |
Harvard | Bio/Vote History | ||
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I am against banning private insurance as a matter of principle.
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Bengt Holmström |
MIT | Bio/Vote History | ||
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Caroline Hoxby |
Stanford | Bio/Vote History | ||
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I am certain that I am uncertain (and do not see how anyone knowledgeable could be certain).
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Hilary Hoynes |
Berkeley | Bio/Vote History | ||
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Medicare has better outcomes than medicaid (higher reimbursement rates)
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Kenneth Judd |
Stanford | Bio/Vote History | ||
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Care is expensive for all, many in middle class would get inferior service and will sacrifice the monetary savings (if any) from a).
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Steven Kaplan |
Chicago Booth | Bio/Vote History | ||
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Anil Kashyap |
Chicago Booth | Bio/Vote History | ||
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the details matter and there are all kinds of offsetting forces, very hard to know which effects would dominate
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Pete Klenow |
Stanford | Bio/Vote History | ||
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Jonathan Levin |
Stanford | Bio/Vote History | ||
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Eric Maskin |
Harvard | Bio/Vote History | ||
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William Nordhaus |
Yale | Bio/Vote History | ||
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Maurice Obstfeld |
Berkeley | Bio/Vote History | ||
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Emmanuel Saez |
Berkeley | Bio/Vote History | ||
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Larry Samuelson |
Yale | Bio/Vote History | ||
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Health outcomes would be increased for the currently uninsured, with (one hopes) no deterioration for the currently insured.
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José Scheinkman |
Columbia University | Bio/Vote History | ||
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However, universal coverage with complementary private insurance and copay (as France) would deliver better outcomes.
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Richard Schmalensee |
MIT | Bio/Vote History | ||
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Some rural hospitals would close, and excess demand would mean longer waits for many. But many uninsured would get effective care.
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Carl Shapiro |
Berkeley | Bio/Vote History | ||
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Robert Shimer |
University of Chicago | Bio/Vote History | ||
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James Stock |
Harvard | Bio/Vote History | ||
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Richard Thaler |
Chicago Booth | Bio/Vote History | ||
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Christopher Udry |
Northwestern | Bio/Vote History | ||
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