Overview

In this long-awaited updated edition of his groundbreaking work Priceless: Curing the Healthcare Crisis, renowned healthcare economist John Goodman (“father” of Health Savings Accounts) analyzes America’s ongoing healthcare fiasco—including, for this edition, the failed promises of Obamacare.

Goodman then provides what many critics of our healthcare system neglect: solutions.

And not a moment too soon. Americans are entangled in a system with perverse incentives that raise costs, reduce quality, and make care less accessible. It’s not just patients that need liberation from this labyrinth of confusion—it’s doctors, businessmen, and institutions as well.

Read this new work and discover:

• Why no one sees a real price for anything: no patient, no doctor, no employer, no employee
• How Obamacare’s perverse incentives cause insurance companies to seek to attract the healthy and avoid the sick
• Why having a preexisting condition is actually WORSE under Obamacare than it was before—despite rosy political promises to the contrary
• Why emergency-room traffic and long waits for care have actually increased under Obamacare
• How Medicaid expansion spends new money insuring healthy, single adults, while doing nothing for the developmentally disabled who languish on waiting lists and children who aren’t getting the pediatric care they need
• How the market for medical care COULD be as efficient and consumer-friendly as the market for cell phone repair... and what it would take to make that happen
• How to create centers of medical excellence, which compete to meet the needs of the chronically ill
• And much, much more ...

Thoroughly researched, clearly written, and decidedly humane in its concern for the health of all Americans, John Goodman has written the healthcare book to read to understand today’s healthcare crisis. His proposed solutions are bold, crucial, and most importantly, caring. Healthcare is complex. But this book isn’t. It’s clear, it’s satisfying, and it’s refreshingly human.

If you read even one book about healthcare policy in America, this is the one to read.

Contents

Preface

1. Introduction

PART I: Why We Are Trapped

2. How Healthcare Is Different
3. Why People Disagree About Health Policy
4. Why People Disagree About Health Policy

PART II: The Consequences of Being Trapped

5. What Being Trapped Means to You
6. Why Do We Spend So Much on Healthcare?
7. Why Is There a Problem with Quality?
8. Why Is There a Problem with Access to Care?
9. Why Can't You Buy Real Health Insurance?

PART III: Letting People Out of the Trap

10. Empowering Patients
11. Liberating Institutions
12. Designing Ideal Health Insurance

PART IV: Letting Government Out of the Trap

13. Solving the Problem of Patient Safety
14. The Do-No-Harm Approach to Public Policy
15. Reforming Medicare
16. Reforming Medicaid
17. Conclusion: Principle for a New Healthcare Order
    

Notes
Index
About the Author

Detailed Summary

Summary PDF

4 pages, 391 KB

• Since the first edition of this book was published, the Affordable Care Act (Obamacare) has transformed the American healthcare system—and not for the better. Obamacare advocates promised not only to eliminate money as a barrier to healthcare access, but also to reform completely the practice of medicine itself. A decade has now passed, and the results are in. Healthcare has not become more affordable; high-quality care has not become more accessible; healthcare delivery has not become more efficient; and no, we’re not getting more healthcare. Nor are we getting healthier. Options for patients with preexisting conditions, for example, are worse than ever. How did all this happen? In this book, John C. Goodman explains why the rosy political promises of pro-Obamacare politicians fell flat.
• As it stands, everyone is trapped—not only patients, but also doctors, businesses, and medical institutions. Everyone is trapped in a web of perverse incentives that raise costs, reduce quality, and make care less accessible. Why is that? Our thirdparty- payer health insurance system still has the prices for care set by entities external to the doctor-patient relationship—with the most external of all possible parties, the government, now playing the leading role in the obfuscation. This lack of price competition inevitably leads to almost-zero transparency, no competition around quality, and the often radical price differences between providers we have today.
• Traps have consequences. It’s not that patients, doctors, nurses, hospital administrators, employees, employers, and even insurance companies do not know how to deliver good healthcare to Americans. And there are many things healthcare professionals could do to avoid waste, increase accessibility, and make care less expensive. But the system we have penalizes doing the right things and rewards doing the wrong things. Doctors are said to have too much freedom to provide treatments that are not “best practice” or “evidence-based”; patients are said to have too much freedom to patronize doctors and facilities they prefer. Therefore, pundits and wonks argue that government must tell doctors how to practice medicine and tell patients what care they can have and where they can get it. This is the opposite of what needs to be done, and Goodman explains why.
• Goodman offers solutions. How can we create centers of medical excellence designed actually to treat Americans—not exclude them, as is the current practice? How could the market for medical care be as efficient and consumer-friendly as, say, the market for cell phone repair? How can patients save money? How can doctors get even better at what they do—and make more money? Are these things even possible, when our current system is so broken? Yes, says Goodman.
• There is a way to get people and government out of the trap. That we need a new way of thinking is obvious. The good news is that there are literally thousands of healthcare entrepreneurs, any one of whom could rise to the level of Bill Gates or Steve Jobs in healthcare. Unfortunately, their efforts tend to be scattered and limited. Most of the time, they run into three major barriers: insurance companies, employers, and government. But despite these odds, new products and new services have continued to crop up to meet the needs of patients spending their own money. Goodman lists many hopeful examples that show how his ideas have already taken hold and, if not stifled by government regulation, could help more patients. Each initiative, however, was developed by the private sector. Liberated from legal impediments and suffocating bureaucracies, doctors, patients, hospital personnel, and profit-seeking entrepreneurs are perfectly capable of solving our most serious health policy problems. All they need is the freedom.

In this long-awaited second edition of his groundbreaking work Priceless: Curing the Healthcare Crisis, renowned healthcare economist John Goodman (the “father” of Health Savings Accounts) analyzes America’s ongoing healthcare fiasco—including, for this edition, the extra damage Obamacare has inflicted on America’s medical system. Goodman then provides what many critics of our healthcare system neglect: solutions.

Using research data and real-world examples, Goodman shows how empowering patients (by giving them control of their own healthcare dollars), liberating institutions (by repealing “race to the bottom” government policies), and designing new health insurance models (ones that, quite simply, allow patients to control demand and doctors to control supply) can change American life forever. If you read only one book on healthcare, this—again— is the one to read.

What Obamacare Has Done

The second edition of Priceless describes the damage Obamacare has wrought upon American healthcare. Goodman’s preface reminds readers of all those promises, implicit and explicit, made when Obamacare was first getting off the ground.

But in the ten years that have passed, none of these promises has been kept. Healthcare has not become more affordable. High-quality care has not become more accessible. Healthcare delivery has not become more efficient. No one is getting more healthcare. Emergency room traffic has increased, and waiting for care has become more and more common. Patients with preexisting conditions are worse off than ever before. To top it all off, Medicaid has drastically expanded. All this to the tune of billions of dollars. Goodman argues that these failures were almost entirely predictable to those with any economic sense.

Trapped

Goodman’s book is written from the premise that most healthcare problems arise because Americans are trapped.

The most sinister trap of them all— indeed, the one that inspired the title of this book—is the trap of obsessively focusing on the burdens of price barriers to care. On the surface, this is an intelligible and sympathetic concern. But it fails to consider that “nonprice barriers to care” can also be very costly—even more so. Goodman cites Britain’s National Health Service (NHS) as an example. It’s true that citizens in Great Britain have no price barriers to care on paper. But today, a record high of seven million people relying on the NHS are waiting for treatment ... a rate 186 times higher than before the pandemic. Many of those people are waiting in pain. Some will die before they get care. Goodman compellingly argues that “the cost of such waiting for many of them is undoubtedly greater than the cost (to the government) of their treatments.” As they say, time is money.

There are other traps that Goodman describes and condemns in detail, many of which are the fault of the overbearing government. Simply repealing many of these policies would liberate a great number of Americans. For example, most working-age Americans rely on employer-sponsored health insurance. But why do we cling to this health insurance model when it’s so clearly outdated? Because federal tax law generously subsidizes employer-provided insurance. It was only recently, after President Trump issued an executive order, that employers were enabled to deposit funds in employee accounts called Health Reimbursement Arrangements (HRAs), from which employees can pay premiums, tax-free, for coverage they obtain in the individual health insurance market. This is undoubtedly an improvement. However, even this order limits HRA deposits to be used only to buy Obamacare-compliant insurance. The heavy hand of the government blocks patients, doctors, and employers from doing what’s best for them at every turn.

Freeing Patients and Institutions from the Trap

That doctors and hospitals need to find better ways of providing care is obvious. But how? Could it be that there is a way for doctors and hospitals to save taxpayers money, make more money for themselves, and ensure that patients don’t suffer?

Actually, Goodman argues, yes. There is a way. Markets. A free market for health insurance, where people are free to make their own choices, combined with Health Savings Accounts (where patients control demand) and “centers of excellence” (where doctors, not government, control supply), is the vision Goodman casts in Priceless.

The truth is, employers, government bodies, and insurance companies will never care more about patients than patients care about patients. By this logic, empowering patients to control their own healthcare dollars and make their own decisions is obviously a better way to control prices and improve healthcare than leaving impersonal bureaucracies with their hands on the wheel (as is the case now).

Many politicians and pundits complain that too many people are underinsured. In fact, Goodman argues, the opposite is true: “a far greater number are overinsured. That is, too many people are paying insurance companies to pay medical expenses that they could more economically pay themselves.” A shocking number of Americans would be better off assuming risks themselves. In this way, HSAs and HRAs are essential tools to liberate patients.

Better still, “when patients are paying for their care with their own money, providers are free to be unrestricted agents of their patients, rather than agents of a third-party-payer bureaucracy.” Without the heavy hand of government involved, doctors can hone and develop their relative centers of excellence to become the best at what they do.

An example of a “center of excellence” would be the Mayo Clinic. Another example would be the Johns Hopkins Breast Center, which focuses on mastectomies. It’s time to expand this model—and for government to get out of the way.

Designing Health Insurance Anew

There are three features of ideal health insurance that any new design must incorporate. First, insurance must be patient-centered. This is for reasons already discussed: no one cares more about health insurance dollars than the patient to whom those dollars belong.

Second, ideal health insurance must allow insurers to specialize in the business of insurance—not transform insurers into providers of care essentially. Insurers should be free simply to do what they do best: “pricing and managing risk.” The market, of course, can and should still combine insurance and healthcare delivery when and where it makes sense. But as a rule of thumb, we should prevent insurance companies from embroiling themselves in the business of healthcare, which is (by definition) not their business.

Third, consumers need better access to more information. What makes this difficult, in almost all cases, is the heavy hand of government. By getting government out of healthcare, everyone has access to the information they need to make the best choice for them.

Principles for a New Healthcare Order

There are key principles that should govern the purchase of any healthcare plan. For instance: First, patients should pay a price for care equal to its marginal social cost. As it stands, doctors and hospitals are rarely paid real prices for the services they render. Instead, they are paid on the basis of “payment formulas.” This becomes complicated when each payer has a different formula. Medicare, Medicaid, Blue Cross, etc., all pay different prices for the same service. “As a result, there really is no market-clearing price that brings supply and demand together,” Goodman writes.

The second principle follows from this logic: providers ought to receive a price equal to the marginal social value their care creates. If providers also receive a fee less than the value of the service, they will underprovide that service; if they receive a fee higher than the value of the service, they will overprovide that service.

The third principle is that, wherever possible, these prices should be determined in competitive markets. Competitive markets are key to finding out the real worth of services and products. Without a competitive market, the actual social cost and social value of healthcare would be unknown.

Fourth, insurance should be individually owned and portable—i.e., able to travel with people from job to job and in and out of the labor market. Clinging to an employer-sponsored insurance model in an era when precious few Americans can expect to stay with any one employer for long stretches of time is antiquated and foolish. It’s time to get with the twenty-first century.

Fifth, people should be able to switch freely between individual self-insurance and third-party insurance based on their preferences and market opportunities. Right now, tax law subsidizes third-party insurance and severely penalizes individual self-insurance. Unsurprisingly, this means most people opt for third-party insurance, which means that third-party bureaucracies pay every medical bill ... even when it would save patients and doctors time and money for patients to manage these expenses themselves.

Impersonal bureaucracies, shielded from marketplace competition, have run American healthcare into the ground for far too long. The best time for sensible, workable solutions to our healthcare crisis would have been yesterday. The second-best time is today. With uncommon clarity, humanity, and optimism, Goodman fearlessly explains how we can liberate our health from the confinement of bureaucracies and heavy-handed legal impediments; how doctors, patients, hospital personnel, and profit-seeking entrepreneurs can come to the rescue and solve our most pressing problems; and how freedom can unlock the horrible traps we’ve let ourselves lie in for far too long.

Praise

“John Goodman’s Priceless is a must-read, and accessible, guide to understanding what is needed for real reform in healthcare. It cuts right to the heart of the dilemma in healthcare—the absence of a meaningful price system—to suggest why the Affordable Care Act failed to curb the cost and access problems we face and explains how even ‘priceless’ goods benefit from markets.”
—Bobbi Herzberg, distinguished senior fellow, F.A. Hayek Program for Advanced Study in Philosophy, Politics, and Economics, Mercatus Center at George Mason University

“In 2012, John Goodman’s Priceless became the most comprehensive, readable overview of American healthcare then available. In 2024, John replicates that achievement with a second edition. As a market-oriented conservative, but not an ideologue, he often deviates from conventional right-of-center wisdom and expresses gratitude for criticism delivered by thoughtful voices on the left. After numerous liberal reviewers in 2012 proclaimed Priceless to be a must-read, I asked a top-tier Clinton/Obama advisor whether she could recommend a mirror-image book—a healthcare survey by a liberal scholar which conservatives ought to consider a must-read. She said that, to her regret, no liberal had produced such a work. That’s still true, so in 2024, the second edition of Priceless stands as the single best introduction to American healthcare, regardless of whether one agrees or disagrees with John’s philosophy.”
—Robert F. Graboyes, economic consultant and publisher of Bastiat’s Window, Substack

“John Goodman remains one of the clearest advocates for the value of markets, and not governments, in enabling better healthcare, and this book is a superb illustration of his talents. Although many Americans would be against an industry structure where they were mandated to purchase a product from a single monopoly, that’s how health plans of most of the world are set up, including Medicare and Medicaid in the US. Goodman again brilliantly lays out many of the fundamental problems with such an industry structure and demonstrates why citizens would be better served by an industry with voluntary payments to competing plans.”
—Tomas J. Philipson, Daniel Levin Professor of Public Policy Studies Emeritus, University of Chicago Harris School of Public Policy

“John Goodman, the ‘father of Health Savings Accounts,’ has once again delivered a splendid economic analysis of American healthcare, which now accounts for almost one-fifth of the entire American economy. In this second edition of Priceless, he once again focuses on why Americans are paying so much for healthcare, and why we are still plagued with deficiencies in the quality of our care, gaps in coverage, and even worsening options for persons with preexisting medical conditions. Especially enlightening is Goodman’s data-rich assessment of Obamacare, a massive Medicaid expansion combined with unprecedented federal regulatory control over private health insurance markets. While Obamacare did little to expand private insurance coverage, it accelerated cost increases for taxpayers and patients alike. Meanwhile, we have been trapped, Goodman argues, in a web of perverse incentives. America can break out of this trap only through patient power: giving patients control over their healthcare dollars and incentivizing medical professionals to play at the top of their game. Freedom works.”
—Robert Moffit, senior research fellow, Center for Health and Welfare Policy, The Heritage Foundation

“Health economist John Goodman’s Priceless tells us how to improve US healthcare by using prices. Prices work well in guiding our choices of food, haircuts, and cell phones. Goodman shows that the few areas in healthcare where consumers are faced with actual prices, such as LASIK, do well; prices have actually fallen and quality has improved. Why not, he asks, use that knowledge in the rest of the healthcare system? Read and learn.”
—David R. Henderson, research fellow, Stanford University’s Hoover Institution; and former senior economist for health policy with the President’s Council of Economic Advisers

Praise for the First Edition

“I have been following John Goodman’s health policy ideas for as long as I’ve been on Capitol Hill. John’s latest effort, Priceless: Curing the Health Care Crisis, makes it abundantly clear why he is a source of wisdom, insight, and innovative thinking.”
—Paul Ryan, Chairman, U.S. House Budget Committee

“John Goodman’s book Priceless provides more good thinking from the person who taught us that incentives matter.”
—Michael O. Leavitt, former Governor of Utah; former Secretary, U.S. Department of Health and Human Services; former Administrator, U.S. Environmental Protection Agency

“With his head for the practical and his heart for the disadvantaged, John Goodman has long been the clearest and most insightful healthcare thinker we have. Now that our perverse, accidental ‘insurance’ system has reached its inevitable crisis, it’s time we acted on his common sense, fact-based wisdom in Priceless.”
—Mitch Daniels, President, Purdue University; former Governor of Indiana

“Priceless is an important contribution to a market-friendly approach to reforming health care.”
—Martin S. Feldstein, George F. Baker Professor of Economics, Harvard University; President Emeritus, National Bureau of Economic Research

“If liberal commentators wish to sharpen their claws, there is no better stone on which to do it than John Goodman’s book Priceless.”
—Uwe E. Reinhardt, James Madison Professor of Political Economy and Professor of Economics and Public Affairs, Princeton University; former Commissioner, Physician Payment Review Commission

“While many people discuss the problems within our healthcare system, few propose real solutions. John Goodman has written a book that not only accurately describes what is happening with healthcare in our nation, it provides key solutions and answers to a problem that so desperately needs to be corrected.”
—Jeb Bush, former Governor of Florida

“After a year of congressional debate, 2,000 and some-odd pages of legislation, and a Supreme Court verdict, few issues remain more contentious than President Obama’s 2010 Patient Protection and Affordable Care Act, dubbed ‘Obamacare.’ ... Priceless is required reading on the subject.... The central theme of Priceless is that patients, doctors, insurers, and employers should be freed of government encumbrances to interact in the marketplace. Patients should be able to check physician fees to choose combinations of quality, cost and amenities. Doctors should be rewarded for finding innovative ways to lower costs. Insurers should be able to charge premiums that reflect risk, to enable them to service high-risk customers. Employers should be allowed to negotiate portable insurance policies for their employees, one way to help patients with pre-existing conditions. ... For better solutions to this and other problems of providing affordable health care, Ryan, Obama, Romney, and Biden should all read this book.”
—Barron’s

“John Goodman, widely known as the father of health savings accounts, is as provocative and controversial as ever in his timely and important, new book, Priceless: Curing the Healthcare Crisis. His prescription for fixing what ails American health care is to free American consumers to seek the health care that best suits their needs and to free physicians and hospital administrators to provide the best, lowest cost care they can by getting rid of the constraints and disincentives provided by insurance companies and public payers. Essential reading for all who have been frustrated in their search for a workable solution to our health care woes.”
—Gail R. Wilensky, Senior Fellow, Project HOPE; former Administrator, Centers for Medicare and Medicaid Services

“Instead of keeping the market from dealing with preexisting conditions, health care economist John C. Goodman argues, we should encourage it. In a new book, Priceless: Curing the Healthcare Crisis, Goodman offers an abundance of ways in which an unfettered market could address the problems of people with chronic medical needs. One proposal: Employers could buy health insurance that was fully portable—employees would own their policies and could take them from job to job. Another idea: Health Savings Accounts for the chronically ill that would allow disabled patients to manage their own budgets and choose the goods and services that best meet their needs. Still another: ‘health status insurance,’ which would allow individuals to protect themselves against the risk that a preexisting condition could emerge down the road and cause their insurance premiums to rise. What America’s health care landscape needs is more freedom and competition, not less.”
—Boston Globe

“John Goodman has been developing innovative ideas on how to create a better health system, a less expensive health system, a health system with more access for well over two decades. He really was the creator of the health-savings-account model and developed that entire initiative to try to give people increased resources and increased control over their health.”
—Newt Gingrich, 58th Speaker of the U.S. House of Representatives

“There’s no question that today’s health care system is littered with distorted incentives and what John Goodman calls dysfunctionality. This book is a call to arms to do something about it. Even if you don’t agree with all of Goodman’s ideas—and there are plenty I disagree with—you should read this book if you want to be an informed participant in the debate over the future of health care in this country.”
—Peter R. Orszag, former Director, Congressional Budget Office; Vice Chairman, Global Banking, Citigroup, Inc.

“Some might object that all omelets, good or bad, require the breaking of eggs. Granting that the Affordable Care Act involves some dismal economics, what is the alternative to providing affordable care? For alternatives that would move in the direction of free markets, try the recently published Priceless: Curing the Healthcare Crisis, by John C. Goodman. Just for starters, Goodman would ‘liberate the supply side of the market’ by legally permitting nurses and other lower-level personnel to perform a range of services that now require the participation of much scarcer physicians. By increasing the opportunities for these people, we might induce far more supply. That’s another law of economics.”
—Barron’s

“Priceless makes a very persuasive case that liberating people is the key to health reform. When we free the patients and the healthcare professionals from payer and government shackles, we will drive quality up and price down and eliminate an enormous amount of waste.”
—Stephen B. Bonner, President and Chief Executive Officer, Cancer Treatment Centers of America

“John Goodman is always interesting, always provocative. His ideas are not to be ignored.”
—Jim Cooper, U.S. Congressman (D-TN)

“Priceless illustrates the importance of market-based solutions to drive affordability, access, and higher quality experience for today’s empowered healthcare consumers.”
—Angela F. Braly, former Chairman and Chief Executive Officer, WellPoint, Inc.

“Priceless is unique in that it combines a general discussion of the issues in health; access, cost and quality, with specific implications of the Patient Protection and Affordable Act of 2009 on these same issues. The book is provocative and instructive, a combination that is difficult to pull off but done here in John Goodman’s style of combining humor with fact. This book should be on the reading list for everyone interested in healthcare reform.”
—Thomas R. Saving, Jeff Montgomery Professor of Economics and Director of Private Enterprise Research Center, Texas A & M University

“Thirteen years ago I co-authored a book that I thought could cut the Gordian knot of the health care dilemma. The dozens of copies sold proved insufficient to promote the needed revolutionary change. John C. Goodman has now written the book that can do the job. He presents as clear an answer as we are ever likely to see, along with examples from the real world. It’s now our job to make the case in a politically effective way. New thinking is necessary, and Goodman provides it. He argues that a free-market approach is essential; health care must be bought with money that most consumers have reason to see as their own. And while most people would respond to such a proposal with an incredulous roll of the eyes, this perception must change. Goodman’s wonderful volume considers both the theoretical and the practical Economic principles, clearly stated, form the basis for discussion. Policy recommendations include strategic thinking and tactical objectives. Goodman tells us how it all can work, and what political decisions will be required. ... A cornerstone of his analysis is that incentives are more efficient than rules for channeling behavior toward optional solutions. Yet, curiously, this perspective is controversial: Many prefer the authoritarian approach, assuming that incentives will not protect us from individual folly, and will lead us where they intend us to go. ... Goodman argues persuasively that a private-sector approach is the only solution for the long term. ... Goodman is a master of clarity. ... The vigorous pursuit of individual liberty produces a self-correcting system in which increasing equality can occur: John C. Goodman has charted the path.”
—The Weekly Standard

“With Priceless, John Goodman has written a path-breaking book that everyone should read.”
—William A. Archer, Jr. , former U.S. Congressman and Chairman, House Ways and Means Committee

“In a health policy world dominated by old tarnished ideas recycled under new acronyms, it is a pleasure to read Priceless that goes back to first principles, defies pigeonholing, and ends up with imaginative yet eminently practical proposals for reform.”
—Mark V. Pauly, Bendheim Professor; Professor of Health Care Management, and Professor of Business and Public Policy Wharton School; University of Pennsylvania; former Commissioner, Physician Payment Review Commission

“John Goodman is one of the nation’s top thinkers in healthcare policy. His new book, Priceless, will be an important resource for policy makers in Washington and around the country.”
—Kay Bailey Hutchison, U.S. Senator (R-TX)

“John Goodman is a highly influential health policy analyst, organization leader, and entrepreneur whose ideas are always provocative and simply can’t be ignored. You may not agree with every proposal he makes, but he is right on target when he notes that future solutions to unsustainable health-cost growth must convince consumers and patients that they gain from those reforms.”
—C. Eugene Steuerle, Institute Fellow and Richard B. Fisher Chair, Urban Institute

“In Priceless, Goodman argues that doctors are trapped in a dysfunctional system and they need to be liberated. He’s right. Restore liberty. End coercion.”
—Donald J. Palmisano, former President, American Medical Association

“In Priceless: Curing the Healthcare Crisis, John Goodman explains why so many Americans—the sick, the healthy, consumers, employers, medical professionals and insurers—feel trapped by the U.S. health care system. Thankfully, he demonstrates that there are ways to escape the health-care traps, and his solutions deserve serious attention, regardless of one’s political persuasions.”
—John Engler, President, Business Roundtable; former Governor of Michigan

“In the sea of perplexity and inefficiency that characterizes health policy, John Goodman’s new book, Priceless, provides fresh and original insights to help steer us into a system that harnesses individual choice, aligns price and quality, and more effectively utilizes financing to achieve these ends.”
—June E. O’Neill, Wollman Distinguished Professor of Economics and Director of the Center for the Study of Business and Government, Baruch College; former Director, Congressional Budget Office

“John Goodman’s terrific book Priceless is indeed priceless. It offers a breath of fresh air in a tired healthcare debate that demonstrates once again that markets enjoy their greatest advantage in complex settings that call for imaginative solutions that no government-driven system can deliver. Critics may carp that healthcare markets are never perfectly competitive. Goodman offers chapter and verse to explain why market innovation beats top-down schemes by a mile—ACA especially included.”
—Richard A. Epstein, Laurence A. Tisch Professor of Law, New York University

“In Priceless, John Goodman provides a much needed perspective on healthcare issues—he is the leading proponent of using market-based reforms to solve health policy problems.”
—Kevin M. Murphy, George J. Stigler Distinguished Service Professor of Economics, U. of Chicago

“John Goodman’s analysis is incisive and compelling. The insight and innovative thinking in Priceless will be invaluable in avoiding the harms of government-run healthcare.”
—Steve Forbes, Chairman and Editor-in-Chief, Forbes Media

“John Goodman’s timely and important book Priceless has much to like. The presentation of healthcare economics is clear as is the discussion of the perverse incentives in health care. Good writing and clear explanations have always been hallmarks of Goodman’s writing. I particularly like three aspects of this book: the consideration of the role of time prices and the surprising winners and losers that immerge from the healthcare reform legislation; the analysis of the political economy of healthcare systems and Goodman’s explanation of why European systems look and act so differently from ours; and the policy prescriptions to reform health insurance, Medicare and Medicaid. Anyone seriously interested in understanding healthcare reform should look carefully at the proposals offered here.”
—Michael A. Morrisey, Professor of Health Economics and Health Insurance and Director of the Lister Hill Center for Health Policy, University of Alabama at Birmingham

“I have not agreed with Goodman’s emphasis on high-deductible health insurance in health care... But no one who is serious about health reform can afford to ignore the ideas in Priceless.”
—Alain C. Enthoven, Eccles Professor of Public and Private Management Emeritus, Stanford University

“In Priceless, John Goodman’s challenge to the conventional wisdom of a health care system broken because of excessive freedom can not be more timely. As we stand on the brink of hyper-regulating our system further, Goodman cogently argues that our answer is to free our system from the traps policymakers, insurers and providers have built over the decades.”
—Stephen T. Parente, Professor of Finance and Director of the Medical Industry Leadership Institute, University of Minnesota

“John Goodman explains in Priceless why the health sector is so dysfunctional and why problems cannot be solved by adding even more layers of government bureaucracy, regulation, and price distortion. Goodman brings his clear thinking as an economist to explain how we could employ market forces in health care to realign incentives so patients, doctors, and all of the players in the health care marketplace are seeking greater efficiency, higher quality, and better value.”
—Grace-Marie Turner, President, Galen Institute

“From the author of Patient Power, Priceless is a new book about why we need to empower doctors as well as patients.”
—Daniel H. Johnson, Jr., M.D., former President, American Medical Association; former President, World Medical Association

“Everyone who wants to understand the mess Washington has made of health policy should read John Goodman’s incisive book, Priceless. Generations of health reformers have tried to engineer a new system based on regulation and centralized control, only to find higher cost for health care that too often fails to provide value to patients. Goodman has a better idea: replace the perverse economic incentives of first dollar coverage and top-down regulation with real insurance, and let competition work.”
—Joseph R. Antos, Wilson H. Taylor Scholar in Health Care and Retirement Policy, American Enterprise Institute

“Too many American health economists have looked to government to solve healthcare problems, without realizing that government is the fundamental cause of these problems. John Goodman is the welcome exception and his innovative work has been influential in his creation of health savings accounts. His book Priceless is now full of equally useful ideas for restoring healthcare to the market, and when the ACA disappears this book will provide the framework for truly reforming healthcare for all.”
—Paul H. Rubin, Samuel Candler Dobbs Professor of Economics, Emory University

“America is in perilous times. In Priceless: Curing the Healthcare Crisis John Goodman deftly explains how to jettison the overgrown dysfunctional gridlock that prevents reform of healthcare and healthcare entitlements.”
—Earl L. Grinols, Distinguished Professor of Economics and Director of Doctoral Programs Development, Robbins Institute for Health Policy and Leadership, Baylor University

“Goodman has just published a new book, Priceless: Curing the Healthcare Crisis, which offers the prospect of a worldwide revolution in health care policy. With the Supreme Court about to rule on Obamacare, this book could not be more timely. ... In more concrete terms, the revolution begins with Health Savings Accounts (HSAs), which involve health insurance paying all expenses above an annual deductible of preferably $2,500 to $5,000 or possibly more. That insurance is much less expensive with those high deductibles alone, and the savings is put in the HSA savings account and used to pay health expenses below the deductible. Whatever is not spent stays in the account earning interest to pay for future expenses, and can be withdrawn and used for anything in retirement. ... Such HSAs can be expanded throughout the entire health care sector. ... In this book Priceless, Goodman opens up the vista for how health care providers, doctors, hospitals, specialists, etc. can and will respond to patients with such incentives. ... But the health care providers must be freed of the barriers that are currently preventing them from serving patients this way. ... Today, while America enjoys the best and most advanced health care in the world, it can best be described as an East German caricature of the maximum, 21st century, fully capitalist health care that our modern science could support.”
—American Spectator

“Goodman’s Priceless: Curing the Healthcare Crisis is an excellent treatise on the healthcare industry and how our political solutions are making that world increasingly perverse, ineffective, and stagnant. ... In my work I am consistently struck by how many great healthcare delivery ideas are illegal and Goodman showcases many examples of healthcare entrepreneurship which aren’t allowed to take off because of the regulatory environment and the entrenchment of major players. Goodman at once lays a strong foundation for healthcare as a system “too complex for any single individual (or group of individuals) to grasp or understand” and makes a strong case for how much hubris policy has had in trying to address the problems of the industry. Herein lies the most powerful lesson of the book: while it is impossible that any entrepreneur will devise an overarching solution for our healthcare problems we have forgotten how to let process innovators test solutions and chip away at problems the way they do to roaring success in other industries. Goodman pinpoints various turns the US has taken to bring existing private coverage and provision of services under the government umbrella. Woven together, these examples provide a vivid picture of systematically government payers have crowded out private sector solutions. ... Goodman is not shy about exposing the politics of healthcare and how it stands in the way of treating those who need care the most, including the poor and elderly, but this book is no exercise in partisanship. ... Goodman has a strong grasp of realities such as the fact that many acute care services will always be sticky to being provided locally but that ambulatory and elective procedures make up the majority of the market and have the potential for reinventing how healthcare is delivered. Many will disagree with the ideas presented but the book will push the thinking of anyone involved in healthcare. This is especially true since Goodman has a thoroughgoing understanding of healthcare as an industry, a quality which most of the loudest voices in policy sorely lack.”
—Marginal Revolution

“This book takes an extensive but not exhaustive look at the current state of American medicine, the perverse incentives caused by government interference (primarily the discriminatory tax code and various rules and regulations at the federal and state level), and what policy changes Goodman thinks would help. ... If you are a left-wing, pro-ObamaCare ideologue, you are not going to like this book. Virtually every myth espoused by the proponents of national healthcare receives the flogging it deserves with Goodman’s painstaking analysis.”
—Journal of American Physicians and Surgeons

“I recently read a very interesting book by John Goodman titled Priceless: Curing the Healthcare Crisis. Whereas President Obama’s Health Reform plan focuses on increasing access to medical services by expanding the government’s role in the medical marketplace, Goodman advocates reducing regulation and adding flexibility to the health insurance and medical markets. The book is interesting throughout. In this book, Goodman—who has been called the “Father of Health Savings Accounts”—points out THE major problem with public insurance programs: the prices paid from services are incorrect. Special interests (e.g., PhARMA, physician specialty groups, patient advocate groups) have a significant influence over the relative prices paid for medical services. These prices typically do not reflect the true cost to treat a patient. These imprecise prices leads to distortionary behavior and an inefficient allocation of resources. Not only does overinsurnace lead to a moral hazard problem, but providers shift the services they provide patients based on rent-seeking behavior rather than competitions for patients. There has been much praise for this book My impression is that it provides a new vision for how health insurance would work. The current approach where the government funds a larger and larger share of healthcare costs is not fiscally sustainable. I don’t agree with all of Goodman’s points, but his market-driven, deregulated approach does offer an appealing option to the current status quo.”
—Healthcare Economist

“Whether Mitt Romney wins the presidency or President Obama is re-elected, they and Congress would be well advised to read and digest John Goodman’s book Priceless. Whoever is president will soon find himself facing unintended, but often predictable, consequences of the new health care law and also of previous laws. Whether the issue is Medicare or Medicaid, health savings accounts, the tax treatment of health insurance, ths costs and effects of preventive health care, the wastefulness of ‘single payer’ health care systems, or the perverse effects of Obamacare, Goodman brings an encyclopedic knowledge to the issue. A reader who is skeptical of his claims can check one of the literally hundreds of studies and government documents that he footnotes. Goodman alternates between being an idealist who wants to get government out of health care, and being a policy analyst who takes certain goals as given—such as having government give health care aid to low-income people—and considers more efficient ways of achieving them. So, whether you want to make a scase for complete separation of health care and state (as I do), of you’re a legislator who wants to make incremental improvements away from current dysfunctional health care policy, much in this book will inform and help you.”
—Regulation

“John Goodman offers a cure for what ails American healthcare. Proponents of the Affordable Care Act (ACA, aka Obamacare) operated high on ‘the ladder of abstraction,’ as some poor writers and preachers do. That’s why Nancy Pelosi and others said it wasn’t necessary to read the bill before voting for it: They were suite-level politicians voting for an abstract idea, not a program with counter-productive details at street level. John Goodman in Priceless: Curing the Healthcare Crisis (Independent Institute, 2012) illuminates the abstract engineering ideal that animated ACA proponents. ... Priceless repeatedly shows that what on paper seems well-engineered does not work out as planners had hoped. ... Goodman contrasts that engineering approach with an ‘economic approach’ that emphasizes individual decision-making. The operative word for Chapter 10, for example, is freedom: He writes of ‘freeing the doctor ...  the patient ... the employee ... employer ...  the nontraditional workplace ...  the uninsured ...  the kids ...  the parents ... the chronically ill ...  the retirees.’ ... Goodman has many insights. ... He’s right about the need to improve the supply of medical personnel by providing additional incentives, rather than smothering doctors in bureaucratic reporting that kills for many the reason they originally entered medicine: to help others.”
—World Magazine

“Priceless covers what is arguably the most important service/product everyone purchases at some point—health care. This book was written by John Goodman, an economist who is sometimes referred to as the ‘father of Health Savings Accounts.’ Goodman’s book examines how interference in the health market has created perverse incentives as patients, doctors, insurers and other third parties try to make it all work. Professional licensing laws, tax laws, labor laws and employee benefit laws have created unintended consequences which have played a large part in creating the health care system we see today. These artificial laws create an atmosphere that attempts to defy and ignore economic laws. No matter how much we may want to, we simply can’t avoid basic economics. One of the best examples of this is the problem of pre-existing conditions. Goodman points out that ‘Most of the time, the problem of pre-existing conditions arises precisely because health insurance isn’t portable.’ ... So if you are interested in learning more about health care, including how you will be affected by the Affordable Care Act, you may want to read this book.”
—Jeffersonville (IN) News and Tribune

“With health care issues playing an outsized role in North Carolina politics right now, I strongly urge Carolina Journal readers to put John Goodman’s recent book Priceless: Curing the Healthcare Crisis on your e-reader or reading stack. You won’t be sorry. Goodman ... has been one of the country’s leading experts on the economics of health care for more than two decades. Back in the 1990s, his work on patient power and perverse incentives in the delivery of medical services helped set the stage for the creation of health savings accounts and the larger revolution of consumer-driven health care. In Priceless, Goodman discusses this revolution and many other topics related to health care reform. While you might not agree with every proposal he offers, you will learn a great deal about health care policy along the way.... Just about every page of John Goodman’s Priceless offers something that challenges the conventional wisdom, improves your understanding of health policy, or at least makes you think. Highly recommended.”
—Carolina Journal

“John C. Goodman’s Priceless tells the story of a health-care system largely controlled and undermined by the federal government, which is now poised to take over the rest of that system and finish the job of ruining it. The means of this death blow, of course, will be the Patient Protection and Affordable Care Act, or Obamacare—unless Republicans succeed in repealing it shortly after President Obama leaves office in 2017.”
—Claremont Review of Books

“Many thanks for Priceless: Curing the Healthcare Crisis I am pleased to have it and look forward to reading it. Your straightforward, commonsense approach is refreshing, and the book’s publication is well-timed. There is much to be done in providing affordable healthcare for Americans.”
—John Barrasso, M.D., U.S. Senator

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