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Argument: Single-payer health care hinders medical investment and innovation

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Jonathan Cohn. "Creative Destruction. The best case against universal health care." The New Republic. November 12, 2007 - "But one argument against universal health insurance isn't so easy to dismiss: the argument about innovation and the cutting edge of medical care. It goes more or less along the lines of my conversation with Mike Kinsley: In a universal coverage system, the government would seek to limit spending by forcing down payments to doctors and pharmaceutical companies, while scrutinizing treatments for cost-effectiveness. This, in turn, would lead to both less innovation and less access to the innovation that already exists. And the public would end up losing out, because, as Tyler Cowen wrote last year in The New York Times, "the American health care system, high expenditures and all, is driving innovation for the entire world."

Cowen, a George Mason University economist, is a self-described libertarian. But it's not just libertarians, or even just conservatives, who say such things. Liberals have been known to voice similar concerns, albeit more carefully. Notable among them is David Cutler, a highly respected Harvard economist, whose book Your Money or Your Life makes a powerful argument that spending a lot of money on health care is frequently worth it--specifically, that investments in areas like neonatal and cardiovascular care have produced longer and healthier lives, more than justifying their exorbitant price tags. And, while Cutler's work on this subject remains somewhat iconoclastic, most economists would concede that it's possible a universal system could stifle innovation by pushing too hard on prices or applying the wrong kind of scrutiny to medical treatments."

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