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Those who have read Porter's previously published On Competition no doubt recall the excellent material on which he and Teisberg collaborated in Chapter 12, "Making Competition in Health Care Work," originally published in Harvard Business Review (July/August 1994). They collaborate again on this volume in which they examine health care issues in three broad areas: "The first is the cost of and access to health insurance. The second is standards for coverage, or the types of care that should be covered by insurance versus being the responsibility of the individual. The third is the structure of health care delivery itself." Porter and Teisberg explain why the only way to truly reform health care is to reform the nature of competition itself. More specifically, to transform health care by realigning competition with value for patients."How to do so is the central focus of this book."

How to explain dysfunctional competition in health care? Porter and Teisberg suggest several which include "misaligned incentives and a series if understandable but unfortunate strategic, organizational, and regulatory choices by each participant in the system that feed on and exacerbate each other. All actors in the system share responsibility for the problem....The problem is that competition does not take place at the medical condition level, nor over the full care cycle. Competition is the current system is at the same time too broad, too narrow, and too local."

This year in the United States alone, at least $2 trillion will be spent on health care, and costs will continue to escalate. While conducting their research, Porter and Teisberg concluded that there should be no presumption that good quality of health care is more costly. On the contrary, they learned that "better providers are usually more efficient. Good quality is less costly because of more accurate diagnoses, fewer treatment errors, lower complication rates, faster recovery, less invasive treatment, and the minimization of the need for treatment. More broadly, better health is less expensive than illness. Better providers can often earn higher margins at the same or lower prices...so quality improvement does not require ever-escalating costs."

Porter and Teisberg have a convincing, indeed compelling argument in support of value-based competition on results in health care within a system which is "ripe for change"...and change for the better but not for the costlier if competition in health care is redefined and then conducted as Porter and Teisberg advocate. One of the most important benefits would be that the changes they propose would be self-reinforcing. "Changes by health plans and providers to compete on values will reinforce and magnify each other, and will spur innovation by suppliers. As consumers and employers adopt these principles, providers and health plans will be more motivated, and more able, to improve the value they deliver."

For these and other reasons, it is imperative to redefine health care by redefining the nature of health care competition. The alternatives and, especially, the implications and consequences of those alternatives are unacceptable. As noted earlier, "How to do so is the central focus of this book."
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on 20 September 2015
This is the finest healthcare management book I have read. Despite it being written almost two decades ago it encapsulates the key elements of
ensuring value in healthcare. I think that if one reads this book first other books such as "competitive advantage" are even more meaningful when applied to healthcare.

Michael Porter has a style that really is a joy to read. This book will uplift and enthuse all those in the NHS who care to read it.
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on 15 May 2014
This is Porter and colleagues turning their considerable understanding to healthcare and healthcare will be the better for it. Should be widely read, even outside the US, which is its focus, as many of the things that are wrong with healthcare are not just in the US but features how we organise, run, and finance healthcare. The study of Germany which followed this is brilliant.
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on 11 June 2012
Porter and Teisberg are very inspiring about the need to change the way we think and provide health care. This doesn't just go for US but as much for Europe. We see country after country not being able to provide neccesary treatment to people and therefore all stakeholders (HCP, payers, patient groups AND pharma) need to work together with a shared ambition of providing real patient value. The pharma companies have the ability to drive this change in an open and transparent way - to the benefits of patients and society - and NOW is the time!
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on 16 February 2015
I strongly recommend reading this book as well as the company which delivered it to me.
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on 12 September 2014
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on 14 April 2012
Ths book is typical Porter. States the obvious, makes it complicated and use the Harvard publishing machinery to claim thought leadership.
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