The Cure

It's always nerve wracking when a friend publishes a book. What if it's not good? That question never arises with my friend David Gratzer, rapidly emerging as one of this continent's leading experts on free-market healthcare reform.

David comes to this great issue with two great advantages:

First, although the late Milton Friedman praised him as a "natural economist," David in fact was trained as as an MD - and so sees healthcare with the point of view of a practitioner.

Second, David is a Canadian, who has practised under the Canadian healthcare monopoly: a permanent inoculation against any temptation to support a so-called single-payer healthcare system.

David's first book, em>Code Blue< , cooly appraised the state of the Canadian system. The title sums up his assessment: "Code Blue" is hospital code for imminent loss of life. This book won Canada's Donner Prize in 2000, Canada's highest prize for a work of public policy.

David is now affiliated with the Manhattan Institute, and his new book, The Cure , turns a free-market eye on the American healthcare system. Gratzer's question: How is it that the US can simultaneously have such fabulous medicine - and such broad unhappiness with the way that medicine is delivered? His answer: competition, competition, and more competition - that's his "cure."

What makes this book so valuable for policymakers is that Gratzer offers two versions of his cure: one cautious and incremental, another radical and bolder.

His incremental reforms include ideas like allowing different state health insurance policies to be sold across state lines. A New Jersey policy can cost five and six times as much as a Kentucky policy - but there may be people in New Jersey willing to trade some of the converage and litigation opportunities afforded them by the local product for lower Kentucky prices.

His bolder concepts would deploy tax reform to sever once and for all the obsolete connection between employment and health insurance.

Throughout his book offers useful background, clear explanations, and lucid ideas. I can't think of any better place for a conservative interested in the health care problem to start reading and thinking.