- Paperback: 224 pages
- Publisher: Berrett-Koehler; 2 edition (1 April 2010)
- Language English
- ISBN-10: 0982417152
- ISBN-13: 978-0982417157
- Product Dimensions: 21.6 x 14 x 1.4 cm
- Amazon Bestsellers Rank: 680,840 in Books (See Top 100 in Books)
- See Complete Table of Contents
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Product Description
Product Description
Best Care Anywhere uses the VA turnaround to illustrate deeper lessons for the U.S. health care system. In particular, it shows how fee-for-service health care leads to more expensive, less comprehensive, and less effective health care. New to this edition:
- Discussion of vast changes in health care politics since 2007
- New insights on how the VA model will shape 21st century health care
- How Bush administration policies undermined the most successful aspects of VA health care
- Updated coverage of federal information technology initiatives in health care, thanks in part to the success of the VA model in that area
Inside This Book
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Amazon.com:
9 reviews
11 of 11 people found the following review helpful
Delivers on its central premise and way more
28 April 2010
Format:Paperback
Best care anywhere? The VA? You better believe it.
The second edition of "Best Care Anywhere: Why VA Health Care I Better Than Yours" just hit the bookstore shelves and I just lapped it up. I was offered the first edition of this book back in 2007 when I was new to working in health care and so very uninformed about it. This book really swept away the cobwebs in my mind in that I had no concept that the incentives imbedded in our system of medical care delivery did not always encourage the *best* care. It, in fact, encourages *more* care which as we know from decades of work in comparing medical effectiveness (see Dartmouth Atlas of Health Care) actually suggests a negative correlation to outcomes.
In that way, this book very much undersells itself - it's about way more than just the VHA. It does what it sets out to do by spelling out what researchers have found which is that in a broad range of metrics, the care provided our veterans in the Veterans Health Administration is the best care available in America today. It's also telling that this second edition is made available some 3+ years after the original and the data still hold true.
What is this data, you might ask:
* New England Medical Journal noted that the VHA was "significantly better" in all measures connected with fee-for-service Medicare
* Annals of Internal Medicine reported that the VHA was the best in all seven measures of quality in comparison to its private industry counterparts
* RAND study concludes that the VHA outperforms all other sectors of American health care in 294 measures of quality
* National Quality Research Center in Michigan found that the VHA had the highest patient satisfaction of any public or private sector health care system
* Journal of the AMA wrote in 2005 that the VHA "quickly emerged as a bright start of patient safety"
That's not even the whole list. And, by the way, they do it at a per-member cost that is 8% less than private sector counterparts. More value at lest cost. I thought that was only supposed to be possible in the private sector.
Well, as it turns out, another thing the author succinctly points out is medical care does not behave like other markets. The author refers to this phenomenon as Roemer's Law. Put succinctly: in typical markets, increased supply leads to lower prices, in medical care more supply just results in more utilization and higher costs. See, all this stuff in a very small package - and extremely quick read - and you have the makings of a classic. And it is.
The second edition of "Best Care Anywhere: Why VA Health Care I Better Than Yours" just hit the bookstore shelves and I just lapped it up. I was offered the first edition of this book back in 2007 when I was new to working in health care and so very uninformed about it. This book really swept away the cobwebs in my mind in that I had no concept that the incentives imbedded in our system of medical care delivery did not always encourage the *best* care. It, in fact, encourages *more* care which as we know from decades of work in comparing medical effectiveness (see Dartmouth Atlas of Health Care) actually suggests a negative correlation to outcomes.
In that way, this book very much undersells itself - it's about way more than just the VHA. It does what it sets out to do by spelling out what researchers have found which is that in a broad range of metrics, the care provided our veterans in the Veterans Health Administration is the best care available in America today. It's also telling that this second edition is made available some 3+ years after the original and the data still hold true.
What is this data, you might ask:
* New England Medical Journal noted that the VHA was "significantly better" in all measures connected with fee-for-service Medicare
* Annals of Internal Medicine reported that the VHA was the best in all seven measures of quality in comparison to its private industry counterparts
* RAND study concludes that the VHA outperforms all other sectors of American health care in 294 measures of quality
* National Quality Research Center in Michigan found that the VHA had the highest patient satisfaction of any public or private sector health care system
* Journal of the AMA wrote in 2005 that the VHA "quickly emerged as a bright start of patient safety"
That's not even the whole list. And, by the way, they do it at a per-member cost that is 8% less than private sector counterparts. More value at lest cost. I thought that was only supposed to be possible in the private sector.
Well, as it turns out, another thing the author succinctly points out is medical care does not behave like other markets. The author refers to this phenomenon as Roemer's Law. Put succinctly: in typical markets, increased supply leads to lower prices, in medical care more supply just results in more utilization and higher costs. See, all this stuff in a very small package - and extremely quick read - and you have the makings of a classic. And it is.
1 of 1 people found the following review helpful
I am a disabled vet, and this book will open your eyes
23 Jan 2012
Format:Paperback
I wish the author would publish more, and wish everyone would read this.
First, I am one of this countries totally disabled vets.. What does that mean? I have no right to health insurance in this country. No private insurance company will cover me, ever. So the VA is my only access to health care. So if i am over 65 I have a right to health insurance, but not before then...
One thing I have noticed is that the average person has no clue how our health care system operates. It is when you become chronically ill or disabled do you really find out how terrible our system actually is. The author had that exact situation when his wife became sick. Which drove him to research our system.
Political forces have made competition sound like it is the solution to our health care ills, yet it really is laughable. Hospitals cost X amount to operate each year, and they bill whoever to cover the costs. The federal government is who pays for our healthcare, it is no longer the privte insurers who pick up the bill. So the federal government should have control over the hospitals who are not simple non-profits.
The VA provides excellent healthcare for a fraction of the cost. Of course it was not always this way, and I have been on both sides of the quality curve of the VA. It is simply because they do not treat insurance cards like every other health care provider in this country. They are not trying to fill beds and utilize every facility to cover a revenue target.
I love the VA. I get to spend 30 - 60 mins with my doctor, and I get real answers and not the answer that will make him or her the most money. For my injuries, the VA are the experts.
This book is must read for everyone in this country.
First, I am one of this countries totally disabled vets.. What does that mean? I have no right to health insurance in this country. No private insurance company will cover me, ever. So the VA is my only access to health care. So if i am over 65 I have a right to health insurance, but not before then...
One thing I have noticed is that the average person has no clue how our health care system operates. It is when you become chronically ill or disabled do you really find out how terrible our system actually is. The author had that exact situation when his wife became sick. Which drove him to research our system.
Political forces have made competition sound like it is the solution to our health care ills, yet it really is laughable. Hospitals cost X amount to operate each year, and they bill whoever to cover the costs. The federal government is who pays for our healthcare, it is no longer the privte insurers who pick up the bill. So the federal government should have control over the hospitals who are not simple non-profits.
The VA provides excellent healthcare for a fraction of the cost. Of course it was not always this way, and I have been on both sides of the quality curve of the VA. It is simply because they do not treat insurance cards like every other health care provider in this country. They are not trying to fill beds and utilize every facility to cover a revenue target.
I love the VA. I get to spend 30 - 60 mins with my doctor, and I get real answers and not the answer that will make him or her the most money. For my injuries, the VA are the experts.
This book is must read for everyone in this country.
1 of 1 people found the following review helpful
Very Informative
5 Jan 2012
Format:Paperback|Amazon Verified Purchase
I am a graduate student doing thesis work on the healthcare industry and and I also work in the healthcare industry. This book was an excellent introduction to the state of the industry and some of the problems we face. Whether you're researching Electronic Medical Records or healthcare - this book serves as an excellent introduction and guide.
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