Considered America’s top health economist, Dr. Fuchs spent more than 50 years diagnosing the ills of the nation’s health care system, which now accounts for 18 percent of the nation’s gross domestic product.America’s per capita health care costs have long been the highest in the world, with spending Approximately $13,000 per person Even in 2021, Dr. Fuchs and other economists have found that the same quality of care is available in other countries for much less, sometimes at half the cost.
“If you solve health spending, you solve virtually all of your fiscal problems,” he told The New York Times. in 2012. Otherwise, “no matter what we do, it will do little to solve our fiscal problems,” he added.
Dr. Fuchs applied cost-benefit analysis to health care, called for universal health coverage, and criticized high administrative fees, soaring drug prices, and the proliferation of specialists over primary care physicians. Although he cited a lot of data in making his case, his work also demonstrated his abiding concern for social justice and how he and his fellow economists shape policy toward better, more equitable health systems and societies. He was shaped by his belief that he could lead others.
“He believed that economists in general, and health economists in particular, needed to ask big questions,” said his colleague Rylan Einav, dean of economics at Stanford University. university obituary.
Dr. Fuchs was an early proponent of the relative poverty line, along with British sociologist Peter Townsend, who proposed it in 1965 as a way to understand and combat poverty based on changing economic conditions. He then studied the economics of gender and concluded in his 1988 book:Women’s quest for economic equalityDespite more than two decades of feminist activism, the economic gap between men and women was “no smaller in 1986 than in 1960,” she said. (He found one notable exception: “young, white, unmarried, highly educated women,” who, despite falling behind, received significant support from men.) )
However, in his 1974 book “Who Lives?: Health, Economics, and Social ChoicesThis is an elegant 170-page diagnostic paper on the U.S. health care system aimed not at fellow economists but at physicians, policy makers, business executives, and anyone else interested in issues in this area.
“Page by page contains more facts and more enlightening principles than many books ten times as long,” wrote physician and civil rights activist H. Jack Geiger in a book review. . For the New York Times.
“Who has done such a great job of identifying, analyzing, and following through on the key issues (cost of care, access to care, advances in technology) and key areas for a general audience? No,” he added. Draw a clear, rational, and manageable set of conclusions and recommendations for the future. ”
Dr. Fuchs advocated fundamental reforms, including an end to the fee-for-service system in which hospitals are reimbursed for each procedure or test, regardless of how effective or necessary the service is. But there was no easy answer to his words. Transforming the health system meant restructuring entire societies, including striving to reduce poverty, violence, and environmental disasters.
“It’s a short walk from the luxury of upper Park Avenue to the rat-bitten, lead-poisoned children of East Harlem, but for our institution, that distance represents a chasm and a bridge. “It appears powerless to bridge the gap,” he wrote.
Dr. Fuchs retired from teaching in 1995, but remained active well into his 90s, conducting research, publishing papers, and mentoring younger generations of economists and public health officials. Shortly before his death, he completed updating the third edition of “Who Shall Live?” With co-author Karen Eggleston.
Alan M. Garber, a physician and health economist and president of Harvard University, said that nearly half a century after its first publication, Dr. Fuchs’ book remains “the most convincing account of the cost and impact of health care in the United States.” ”.
“His ideas remain relevant to all contemporary policy discussions about how to improve the health of our population,” he added.
Victor Robert Fuchs, the older of two children, was born in the Bronx on January 31, 1924. His parents were Jewish immigrants from Austria, his father a furrier and his mother a housewife. and his younger brother Lawrence, followed him into academia and founded the American Studies Department at Brandeis University. He later served as an advisor to the federal government, helping to shape immigration policy.
After serving in the Army Air Corps during World War II, Dr. Fuchs studied business administration at New York University. He earned his bachelor’s degree in 1947 and worked for his father’s fur company, then completed training in economics at Columbia University and earned a master’s degree in 1951 on the economics of the fur trade. Thesis earned him a Ph.D. in 1955.
Dr. Fuchs’ health care research has its roots at the Ford Foundation, where he worked on economic development programs and was commissioned to write articles on public policy issues. For our article on healthcare, we consulted economist Kenneth Arrow, a future Nobel laureate and colleague at Stanford University, to explore the role of uncertainty and risk aversion in healthcare markets.
This article, published in the American Economic Review in 1963, helped propel health economics into a major field. “In Greek legend, Helen’s beauty launched a thousand ships. Arrow’s paper launched more than a thousand studies,” Dr. Fuchs writes in his essay. After Arrow’s death in 2017.
Dr. Fuchs studied service industries such as retail stores and barbershops before focusing on health care. Wanting to understand the country’s emerging post-industrial economy, he has spent time with doctors and other health care providers since 1968, when he held a joint professorship at the Mount Sinai School of Medicine and the New City University Graduate Center. He said he has more time. yoke.
In 1974, he joined the faculty at Stanford University, holding similar appointments in the School of Medicine and the Department of Economics. Although he was later elected president of the American Economic Association, it was clear to his colleagues that his interests extended far beyond the field. He was known for years for painting, sketching, writing poetry, and performing stand-up comedy at Stanford University events.
His wife, the former Beverly Beck, whom he married in 1948, died in 2007. Her survivors include her four children, Nancy Fuchs Clymer and Fred, Paula and Ken Fuchs; 10 grandchildren. and six great-grandchildren.
Dr. Fuchs’ health reform proposals included plans for a value-added tax-funded voucher system that would guarantee universal health coverage with a standard benefits package. He acknowledged the proposal was “revolutionary,” but said he didn’t think it was completely unrealistic, especially as health care costs continue to eat into the federal budget.
“American history is littered with examples of things that were politically impossible until they actually happened,” he told the Times in 2012. Creation of a strong and independent central bank. Replacement of the gold standard by fluctuations in foreign exchange rates. A $1 trillion bailout for the financial industry.
“Alexis de Tocqueville said that in the United States, things move from the impossible to the inevitable, rather than stopping at the possible,” he continued. “We will make big changes because we are facing a crisis and only big changes will solve it.”
