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Who Killed HealthCare?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure: America's $1.5 Trillion Dollar Medical Problem--and the Consumer-Driven Cure
 
 

Who Killed HealthCare?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure: America's $1.5 Trillion Dollar Medical Problem--and the Consumer-Driven Cure (Hardcover)

by Regina Herzlinger (Author)
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Product details

  • Hardcover: 240 pages
  • Publisher: McGraw-Hill Professional; 1 edition (1 May 2007)
  • Language English
  • ISBN-10: 0071487808
  • ISBN-13: 978-0071487801
  • Product Dimensions: 23.2 x 16 x 3.4 cm
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (2 customer reviews)
  • Amazon.co.uk Sales Rank: 444,475 in Books (See Bestsellers in Books)

Product Description

Review

"Regina Herzlinger's impressive and accessible Who Killed Health Care? offers insights that could lead to real progress. She sets forth a world in which insurance companies compete on quality, product design and disease management--not on ability to attract healthy consumers. Entrepreneurs would create integrated disease-management systems that profit from excellent and effective service, saving patients' time and providing coordinated care for all aspect of a condition." (New York Post )

“Mrs Herzlinger is America's leading advocate of market-driven, consumer-orientated health reform. She wants a national system which requires individuals to buy health insurance, with help in the form of tax breaks for all punters, and subsidies for the poorest. She wants insurance prices to be risk-adjusted and hospitals to be free to charge what they like so they can offer new services as the market demands. Most importantly, she wants the government to demand transparency of price and quality from this notoriously murky industry.”-The Economist (The Economist )


Product Description

A renowned authority from Harvard Business School confronts America's health care crisis-and how consumer control can fix it

PRAISE FOR WHO KILLED HEALTHCARE?

“A brilliant analysis… A must-read.” – Bill George, Professor, Harvard Business School and Former CEO of Medtronic

“As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written.” – Daniel H. Johnson, Jr. MD, former president of the American Medical Association

“Regina Herzlinger’s ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system’s existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control.” – Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass)

“Regina Herzlinger… offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?” – Greg Scandlen, founder, Consumers for Health Choices

“Regi Herzlinger has brilliantly articulated a better way – embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans – not politicians and bureaucrats – back in charge of their health care decisioins.” – U.S. Senator Tom Coburn (R-Okla), M.D.

“Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out.” – Dennis White, executive vice president for strategic development, National Business Coalition on Health

“A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly.” – James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine

“You can practically hear the war chants as Professor Herzlinger sets out her view of what’s wrong with the health care system and how to fix it. You’d best read it so you can decide which side you will be on when the battle is joined.” – Paul Levy, CEO, Beth Israel Hospital, Boston, MA

“Regina Herzlinger, the nation’s leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read.” – Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership

“You don’t have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care.” Peter L. Slavin, MD, President, Massachusetts General Hospital


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5.0 out of 5 stars How to solve America's "$2 trillion medical problem", 28 Jun 2007
By Robert Morris (Dallas, Texas) - See all my reviews
(TOP 100 REVIEWER)    (REAL NAME)   

According to information released by the U.S. Centers for Disease Control and Prevention on June 24, 2007, about 43.6 million people in the United States, or 14.8 percent of the population, had no health insurance in 2006. The finding, based on a survey of 100,000 people, is lower than previous federal estimates of 46 million. The estimate is based on those who did not have insurance at the time of the interview. About 54.5 million people in the country, or 18.6 percent of the population, had no insurance for at least part of 2006. Whatever the exact numbers, there is obviously a very serious problem with health care provision in the U.S. In fact, dozens.

In her previously published book, Consumer-Driven Health Care, Regina Herzlinger explains that consumer-driven health care is "fundamentally about empowering health care consumers - all of us - with control, choice, and information." Such control will "reward innovative insurers and providers for creating the higher-quality, lower-cost services we want and deserve." What would be the role of government? She asserts that "government will protect us with financial assistance and oversight, not micromanagement." The material in this substantial volume is organized within five Parts. Herzlinger wrote the first, "Why We Need Consumer-Driven Health Care," then edited the contributions by others that comprise Parts Two-Five. She also wrote Chapter 78, "A Health Care SEC: The Truth, the Whole Truth, and Nothing But the Truth." For most of us who are not health care professionals, this volume provides about as much information as we could possibly need, much less process. I especially appreciate the fact that Herzlinger and her associate contributors make a conscious effort to avoid jargon, vague theories, oblique hypotheses, etc. They obviously believe that major health care issues are too important to be packaged as flimflam, swamp gas, and flapdoodle. Hence their rigorous focus on explaining (from a variety of perspectives) why consumer-driven health care is needed, and, how to establish and then sustain it.

In this volume, Herzlinger focuses her attention on what she describes as "America's $2 trillion medical problem" (about the current size of the economy in China) and explains why consumer-driven initiatives offer a "cure." More specifically, she exposes "the iron triangle" of third parties (i.e. Congress, health insurers, and hospital administrators) that have opposed consumer-driven health care and thereby subordinated, if not totally ignored the welfare of patients as well as their personal physicians (if they have any). These third-parties are the ones who have "killed" health care for tens of millions of uninsured or under-insured people who, Herzlinger insists, have been deprived of power, information, and choice. She is a passionate and well-informed advocate of nothing less than major, extensive, and comprehensive health care reform.

"Four armies are battling to gain control [of health care]: the health insurers, hospitals, government, and doctors. Yet you and I, the people who use the health care system and who pay for all of it, are not even combatants. And the doctors, the group whose interests are most closely aligned with our welfare, are losing the war." What to do? Herzlinger's convincing, indeed compelling and eloquent response to that question is best revealed within her narrative. However, for present purposes, here are a few key recommendations:

1. Consumers must take back the money their employers and government now take from their salaries and taxes to buy health insurance on their behalf so they can make their own purchase decisions.

2. Physicians must be empowered to design better, cheaper health care.

3. The destitute must be subsidized by "the rest of us" so that can purchase health insurance "like everybody else."

4. The federal government must help subsidize the destitute, provide transparency (a key factor for all consumers, actually), and prosecute fraud and abuse.

In Parts 1 and 2, Herzlinger explains who is killing health care and how they are doing it. She identifies both "villains" and "heroes." In Part 3, she "lays out the principles as well as the specifics of consumer-driven health care - what it is, why it will work, what it offers to all of us - and analyzes the lessons from consumer-driven systems like Switzerland's." Then in Part 4, Herzlinger provides a step-by-step plan "of the carrots, the sticks, and the laws that will make this consumer-driven system happen."

Many of those who read this brief commentary of mine may ask "So what?" Perhaps they are satisfied with their current health care coverage. It is possible but unlikely that many (if any) of those who are destitute - who have no health care insurance coverage whatsoever - check out reviews of books, much less purchase and then read them. The fact is, those who are satisfied with their current health insurance coverage are probably paying too much for their share of its total cost. And a separate but related fact is that their employer is also paying too much for its share of the health care coverage that it is required by law to provide to its full-time employees.

Herzlinger has a crystal clear vision of what health care should be and do but she is also a pragmatist. She fully understands that unless and until, in a democratic capitalistic society such as the U.S., incentives and rewards are changed, there can be no reform of the current health care system. It is wholly understandable that "the iron triangle" of third parties (i.e. Congress, health insurers, and hospital administrators) oppose consumer-driven heath care, especially given the fact that about $2 trillion is involved and would be at risk if (huge "if") patients were entrusted with the power to decide how that money would be spent.

My concerns, frankly, are these: How many people will read this review and others, then purchase and read Herzlinger's book? Then what (if anything) will they do? All change initiatives inevitably encounter what James O'Toole has aptly characterized as "the ideology of comfort and the tyranny of custom." The power and resources of those who defend the status quo of "the iron triangle" must not be underestimated. All by herself, Regina Herzlinger cannot reform the current health care system. Who will join her in doing everything humanly possible to make consumer-driven health care a reality? If you think you wish to enlist in this "war" and help win it, I suggest you read and then re-read Pages 254-258, then contact your representatives in the House and Senate and insist - not request - that they read this book or at least have a staff member do so. Will that do any good? I have no idea. But I do know that by remaining silent and compliant, we empower "the iron triangle" rather than ourselves.

Presumably much of what Herzlinger reveals about health care waste, redundant costs, bureaucratic quagmires, comparable "iron triangles," etc. in the United States is relevant to health care systems in other countries. However many differences there may be between and among health care systems throughout the world, they must address the same social, economic, and medical issues...all of which Herzlinger examines with passion, discipline, and eloquence in this book.
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5.0 out of 5 stars Reviving the moribund, 4 Nov 2007
You do not have to agree with Herzlinger's views on healthcare management but if you are interested in or a part of the healthcare system you do need to read this book.

I will not rehearse the issues raised in the book - this has been done very well in the review above.

Regina Herzlinger is a respected commentator and academic who has been writing about healthcare and her personal vision of consumer-driven healthcare for many years. She pulls no punches - one of the reasons this book is so appealing - and you get that sense of power in the opening prose when Former President Nixon is described as 'the Prince of Darkness' in relation to what he did to support the growth of Health Maintenance Organisations (one of Herzlinger's contributors to killing healthcare in the US).

In an imperfect world of healthcare provision there is much pontificating and soul searching. Herzlinger takes the reader through symptoms and diagnosis of the problem and clearly sets out a new way of managing and providing much needed care; hers is a voice that needs to be heard in the healthcare reform debate (at home in the US and abroad).
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