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2030 The Future of Medicine: Avoiding a Medical Meltdown Paperback – 4 Feb 2011
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Making care truly personal, redesigning how we deliver it, and creating incentives to progressively improve outcomes and productivity are at the heart of what we need to do. And it will be obvious from this list that only the overall framework can be established by government the rest is up to health system managers, medical professionals and all of us as patients. (SCOPE)
The book reads with ease. The chapters are focused and the subject well-described. I liked the breakdown of the chapters in small parts, well and clearly titled. This helps to maintain the attention on a subject that can be rather dry...A thorough and very helpful overview of the impact that globalisation is having on the struggle countries face in their efforts (or lack of them) to try to manage the effects of drinking alcohol in their population and the impact on the publlc health of their nations...I can see myself referring back to this book again and again in future as I assess my personal role in the health sector and engage colleagues and patients in the debate to determine what will be the best option(s) for the future. (BMA Med Book & Patient Info)
An accessible and comprehensive snapshot of the complex healthcare environment with which policy makers wrestle...A must read for those who want to be part of solutions to get best treatments to the most people and allow us all to benefit from one of the most remarkably exciting fields of human activity...understanding and fixing ourselves. (Andrew Witty, Chief Executive GlaxoSmithKline)
This book is a must for healthcare leaders on both sides of the Atlantic. It grapples with the big question of how we can afford the future. (Ken Jennings, Consultant to leading US health systems)
The next 20 years will see huge strides in how medical science could transform our lives. This book not only describes what will be possible but also whether and how we can afford it. (Professor George Poste, Del E. Webb Chair in Health Innovation, Arizona State University)
A very engaging and enjoyable read, covering a colossal amount of ground without feeling stretched...translating the more upstream science into practical implications for the general public. A great primer on the health future - for both the health-informed and those coming to such thoughts for the first time. (Sam Lister, Health Editor, London Times)
The author is to be congratulated: a well-rounded synopsis of the "present to the future" situation in healthcare...skillfully balancing the transition from basic to applied science, to healthcare and to potential political and economic solutions. (Professor Sir Alasdair Breckenridge, Chairman, UK Medicines and Healthcare Products Regulatory Agency)
This book offers a penetrating analysis of the underlying problems, and offers some simple, but far-reaching solutions to bring supply and demand back into balance and avoid the meltdown. It is not a contribution to the current political debate but a primer for the changes to the underlying fabric of healthcare if reforms such as "Obamacare" have any chance of sustainable success. (Gorilla)
The book goes where few go, and that is to compare issues in the U.S. and U.K. and note how some issues such as need for redesign are similar even though the healthcare payment or insurance models are different. (Doody's Reviews)
Barker's book is a brief and excellent primer on current and possible future trends in medical care. His readable prose captures and synthesizes well the current thinking on how to deal with costs associated with medical advancement. (Health Affairs)
About the Author
Richard has spent most of his career in healthcare, as a leader of organisations, as a board member and as a consultant. His leadership roles have spanned therapeutics, diagnostics and informatics both in the United States and in Europe. He was recently voted as one of the top 50 most influential people in UK healthcare and he sits on several healthcare and life sciences advisory boards on both sides of the Atlantic. His passions include securing a sustainable future for healthcare and redesigning how new medical technology is brought into practice. He now lives in London but is a frequent visitor to the US, where he spent 11 years working in Boston, New Haven, New York and San Francisco.
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In this book Richard successfully reduces the complexity of the issues facing us by personalising them into specific family situations that we can all understand. He is bold enough to identify the channels we should be focusing on to find solutions, such as personalised medicine. No-one is clever enough to come up with a complete solution immediately, but by pointing us towards the requirement for integration of our approach to chronic disease and using the power of information Richard identifies the levers we should be experimenting with - and soon - to alleviate the build-up of further liability.
We got into an economic crisis because we did not respond quickly enough to the warning signs - Richard provides us with an avenue of response that can help direct our actions to prevent a similar crisis in health care.
This book not only sets out a vision for what an economically sustainable healthcare system might look like, but also the preconditions for getting there. It sets out quite bleakly the challenges we face as our societies get older and physically weaker - we will have in our collective hands more impressive and potent tools to maintain life and health, but risk lacking the resources to make them widely available. To be able to afford the healthcare we expect and hope for, we need to start now to make some fundamental changes in the way our healthcare systems are developing.
The book lists ten major drivers of a viable long-term healthcare system. Two of them particularly stuck in my mind:
* Personalisation of medicine - using patient information to prescribe the most effective treatments for the individual, rather than the condition. This will increase effectiveness and reduce waste. To be really effective it also requires patients to have more access to their own information, so that they can make better-informed judgements about their own health, and changes the role of the doctor from omnipotent judge to specialist advisor.
* Refocusing healthcare commissioning on increasing the health of the population, rather than just limiting the effects of critical conditions. Most of today's healthcare commissioning, by the NHS and by health insurers is focused on responding to ill-health. We in the UK have a National Ill-health Service. This book argues that it would be far more cost-efficient to capitise healthcare commissioning, making the budget holder responsible for maximising the health of the group for whom they are responsible. This would increase the emphasis on preventative medicine, but lower longer-term costs.
This second point is particularly significant for the current UK healthcare legislation, and it suggests that some of the heat in the UK healthcare discussion is mis-focused. It is perhaps less important who does the commissioning, Primary Healthcare Trusts or Consortia of GPs, than how they do the commissioning. The book recommends that they be more focused on outcomes than activities, and that they should be incentivised to maximise the health of the population, not just ameliorate illness.
I first met the author, Richard Barker, over 20 years ago, and was impressed by his intellectual acumen and passion for problem solving. Since then he has been at the centre of the British medicines industry as Director-General of the ABPI. The future of healthcare is perhaps the biggest problem our society faces over the foreseeable future, so this book should be a must-read for anyone involved in or concerned about the future of medicine.
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