What Would Eli Ginzberg Think of MAGAnomics?

Posted on | July 29, 2025 | 1 Comment

Mike Magee

“The Monetarization of Medical Care.” It had appeared in the New England Journal of Medicine 13 years earlier, on May 3, 1984, and was written by a Columbia University economics professor named Eli Ginzberg.

At the time I first read it, doctors were in an upheaval in Massachusetts. Managed Care and Health Maintenance Organizations (HMO’s) had begun to drive a wedge between generalists and specialist doctors; medical liability costs were going through the roof; for-profit hospitals were beginning to challenge the non-profits; and the new health consumer movement was just emerging. The Boston Globe was writing articles about “doctor malaise.”

Into this mix came Dr. Ginzberg’s paper which traced the corrosive impact of money on every element of health delivery since the 1950’s, from doctors to hospitals, and from philanthropists to manufacturers.

As for solutions, he summarized the issue in the next to the last paragraph this way, “…only the naive believe that the goals that must be pursued — innovation, quality, access, and equity at an affordable cost — can be achieved either by greater reliance on the for-profit sector or by radically constraining its growth.” My opinion in 1997, a decade after its publication: The status-quo will not be an option forever. Change is coming. So I decided to track down the famous Columbia economist myself.

A few calls later, I found myself speaking with Eli. I told him who I was and that I had admired his work for some time, and asked him whether he might like to join me for lunch. He said yes, and I asked him where he would like to go, what was convenient for him? “How about the Oak Room at the Plaza?”, was his immediate response.

As the clock struck 12:30 the following day, I was seated in one of “the wrap-around couches along the western wall” of the Oak Room when Eli Ginzberg entered, larger than life.

He was a short but spry 86 year old man. His face was alive and his eyes sparkled with a combination of humor, extreme confidence and good will. His hair was thick and white and coarse, his eyebrows unruly, and he had a mustache that belonged. He was dressed carefully in an old-cut suit, with white shirt and loosely knotted silk tie drawn almost up to his neck. His shoes were polished but scuffed.

He was present. His voice was strong, but not overpowering. First impression: a wise man, accessible and open; a complex man with powerful communication skills.

Others described this adviser of eight American presidents as a “maverick economist,” for his willingness to break out of the well defined boundaries of economics, and cross over into areas of psychology, organizational dynamics, and human resource theory. The famous Stanford University health economics professor, Victor Fuchs, described him as a pragmatic individual who approached a challenge “with a hard-headed view, not seeking villains or imagining that there are easy solutions to difficult problems…(an individual who felt) that a combination of clear thinking and compassion could bring us closer to the best of all possible worlds – but he is not sure that it will.”

Former Secretary of State George Schultz said of him, “The list of original ideas which came from his thinking is long and important.” But in looking back on his own research and successes over the years, Eli’s self-assessment was more pessimistic and critical, believing it was “a mixed bag, with a few successes, some contributions, and many efforts that resulted in few if any positive results.”

That first lunch, we talked for nearly an hour and a half, before he suddenly said, “I have an appointment.” But we’d meet again, six more times before he died on December 15, 2002, always for lunch, and always at the Oak Room at the Plaza. Over the course of those meetings we discussed a wide range of issues, some mine, but often his. That pattern was set at our very first lunch.

On that first day, I had begun by showing up with my wilted copy of his 1984 article which he recalled in detail. When he saw the article itself, ripped from my copy of the journal years before, he seemed somewhat taken aback. As we ate, he instructed that the competitive market approach to health care (including pharmaceuticals) would never deliver efficiency, a balance of high quality and reasonable cost; that poverty and nutrition were essential critical determinants of health; that the uneven distribution of doctors was the result of doctors gravitating to locations where they could earn the best living; and that expensive modern highly specialized and technology laden hospitals could not be sustained in low income areas without support.

But he was also interested in talking about other elements of his life – his intellectual pursuits and accomplishments, the people he had known, and met, and worked with. He was especially proud of his work with the military in World War II, and would return to it again and again over the next few years.

He had been attached to Columbia for nearly six decades, but that barely told his story. His father was Lithuanian and had been educated in Germany. German was Eli’s native tongue. In 1928, when he was 17, and about to enter his sophomore year at Columbia, his professor father, a leading expert in rabbinical law at Jewish Theological in New York, took a sabbatical leave to establish the department of Jewish Law at the Hebrew University of Jerusalem. With the family in transit, Eli enrolled for a year at the University of Heidelberg in Germany where his father had trained. Some years later, in an interview, he recalled, “I was in my more aggressive mood. I had very substantial interest in psychoanalysis. I even thought, for a very brief time at Heidelberg, that I would maybe study medicine. I wasn’t interested in medicine, and I wasn’t interested in dealing with eight patients a year, but never the less Freud had made a big impression on me.”

But after one year, he returned to Columbia, and in a combined undergraduate and graduate program earned a bachelor’s degree and his PhD in 1934 at the age of twenty three. It was the middle of the Depression, and FDR was struggling to uncover strategies to incorporate into the New Deal legislation. Eli sensed the opportunity and managed to secure a fellowship focused on uncovering the secrets of successful corporations.

Over the next year he embarked on a road trip that would take him to 46 states and many of the nation’s largest corporations including Kodak, General Electric, Proctor and Gamble, General Motors, Sears Roebuck, International Harvester, Humble Oil in Texas, Metro Goldwyn Mayer, U.S. Steel, and Goodyear. He summarized his findings three years later in a book titled “The Illusion of Economic Stability” around the same time that FDR and Supreme Court Justice Charles Evans Hughes were locked into their “Court Packing” struggle.

By then, he had become a known expert in workforce planning and jobs. He was focused on “human resources” before that term had entered the business school vernacular. In 1939, he began to explore in earnest the issue of economics and group behavior. What motivated productivity and success? Could one predict manpower needs better if you really understood what made people tick and integrate that with excellent analysis of the hard facts. The new field of industrial psychology was just being born and it was a perfect match for the young researcher already developing a reputation as a “maverick economist”.

One can only wonder now, 23 years later, what the maverick himself might have had to say about the state of America and the world. Would he embrace or resist AI? Would he be surprised by America’s isolationist turn or the attacks on the CDC, NIH, and FDA? Would the man who shook hands with his uncle (JFK) and his father make peace with RFK Jr?

Comments

One Response to “What Would Eli Ginzberg Think of MAGAnomics?”

Mike Magee
July 30th, 2025 @ 9:25 am

Eli Ginzberg was the primary architect of America’s multi-stage rapid casualty evacuation program for injured soldiers in WW II. He is credited with saving the life of Bob Dole and many others.