Big Think Interview With Jacob Hacker | Big Think

Big Think Interview With Jacob Hacker

New videos DAILY

Join Big Think Edge for exclusive videos

----------------------------------------------------------------------------------

A conversation with the Yale political science professor and healthcare expert.

----------------------------------------------------------------------------------

Jacob S. Hacker:

Jacob S. Hacker, Ph.D., is the Stanley B. Resor Professor of Political Science at Yale University and a Resident Fellow at the Institution for Social and Policy Studies. He is also a Fellow at the New America Foundation in Washington, D.C., and a former Junior Fellow of the Harvard Society of Fellows. His 2007 proposal for universal health insurance, "Healthcare for America," was instrumental in bringing the "public option" to the forefront of the national healthcare debate. He has testified before Congress and written articles for a variety of publications, including The New York Times, The Washington Post, The Nation, and American Prospect. His most recent book, "The Great Risk Shift: The New Economic Insecurity and the Decline of the American Dream," was published by Oxford University Press in 2006 (paperback, 2008).

----------------------------------------------------------------------------------

TRANSCRIPT:

Question: What has been your personal experience with the healthcare system?

Jacob Hacker: Well, I think my experiences with the healthcare system have been pretty similar to most Americans. I was born into American healthcare and have grown up not aware that there was anything different. When I was in college, I went and worked on Capital Hill for then-Representative Ron Wyden—he has since gone over to the Senate side—for his chief health assistant. While I was there I came to discover not only what I had already known, which is that there are a lot of problems in American healthcare, but that our system was very different from those systems in other countries.

So one of the things I did when I went back to college after that summer is started studying why the United States had ended up with such a distinctive system, and ended up writing my senior thesis on the rise and eventual fall of the Clinton health plan, and wrote my dissertation while I was at Yale on the development of America’s distinctive system of workplace social benefits, including healthcare but also retirement pensions.

So I've been studying this now for most of my adult life, and at the same time I've gotten more and more involved in it as a participant in the debate rather than just a student of it. The story there, which is worth telling, is that as I was studying the development of our distinctive system, I was always wondering why is it that it's so hard to reform American healthcare. After all, we've had efforts from the early 20th century to try to do this, to really address the problems in American healthcare, and they've only grown worse. My answer was that it's hard in part because we failed in the past and we've come to rely so heavily on the sort of jerry-rigged system of private employment-based benefits. And that Americans, while they're worried about the cost of those benefits and worried about their security, and millions of Americans don't have coverage at all or who are unprotected against medical costs, that at the same time people are fearful of changing the arrangements they've come to rely on.

That's why it's so hard. And I think that's the central reason why this debate is so bitter and fierce. There is really a lot of fear that can be provoked by opponents of reform, and it's amazing we've come as far as we have in the debate, given the history of past defeats.

Question: How did the ideas in “Healthcare for America” go from theory to policy?

Jacob Hacker: Well, it's been a bracing experience in some ways, because every academic dreams in their spare time, or at least a lot of academics dream in their spare time, that they're going to have a big influence on national policy debates. But I think our vision of what that would be like is sort of similar to our own experiences in the academic world, that somehow going into a Washington policy debate is like having a seminar where you're talking about your ideas and other people are respectively disagreeing or agreeing. It's been really exciting to be involved in the debate, but it's very tough. There is a lot of criticism of some of the ideas that I put out, and I feel enormously gratified that I've had influence. At the same time, I've definitely learned that being involved in big policy debates is not for the faint of heart. I think the main thing is that I got involved in this debate because I feel as if the system we have today is failing too many Americans and that we have to act to reform American healthcare.

Read the full transcript at