Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price


Jonathan Cohn - 2007
    Every day, millions of hard-working people struggle to find affordable medical treatment for themselves and their families—unable to pay for prescription drugs and regular checkups, let alone hospital visits. Some of these people end up losing money. Others end up losing something even more valuable: their health or even their lives. In this powerful work of original reportage, Jonathan Cohn travels across the United States—the only country in the developed world that does not guarantee access to medical care as a right of citizenship—to investigate why this crisis is happening and to see firsthand its impact on ordinary Americans.The stories he brings back are tragic and infuriating. In Boston, a heart attack victim becomes a casualty of emergency room overcrowding when she is turned away from the one hospital that could treat her. In South Central L.A., a security guard loses part of his vision when he can't find affordable treatment for his diabetes. In the middle of the prairie heartland, a retired meatpacker sells his house to pay for the medications that keep him and his aging wife alive. And, in a tiny village tucked into the Catskill mountains, a mother of three young children decides against a costly doctor's visit—and lets a deadly cancer go undetected—because her husband's high-tech job no longer provides health insurance.Passionate, illuminating, and often devastating, Sick interweaves these stories with clear-eyed reporting from Washington and takes us inside the medical industry to chronicle the decline of America's health care system—and lays bare the consequences any one of us could suffer if we don't replace it.

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care


T.R. Reid - 2009
    R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost. In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid sees problems too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right?The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate: Is health care a human right?

Innovator's Prescription


Clayton M. Christensen - 2008
    . .Our health care system is in critical condition. Each year, fewer Americans can afford it, fewer businesses can provide it, and fewer government programs can promise it for future generations.We need a cure, and we need it now.Harvard Business School's Clayton M. Christensen--whose bestselling The Innovator's Dilemma revolutionized the business world--presents The Innovator's Prescription, a comprehensive analysis of the strategies that will improve health care and make it affordable.Christensen applies the principles of disruptive innovation to the broken health care system with two pioneers in the field--Dr. Jerome Grossman and Dr. Jason Hwang. Together, they examine a range of symptoms and offer proven solutions.YOU'LL DISCOVER HOW"Precision medicine" reduces costs and makes good on the promise of personalized careDisruptive business models improve quality, accessibility, and affordability by changing the way hospitals and doctors workPatient networks enable better treatment of chronic diseasesEmployers can change the roles they play in health care to compete effectively in the era of globalizationInsurance and regulatory reforms stimulate disruption in health care

America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System


Steven Brill - 2015
    It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation.   But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury. Praise for America’s Bitter Pill   “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times   “An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.” —The New York Times Book Review   “A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”—Los Angeles Times  “A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”—The Daily Beast  “One of the most important books of our time.”—Walter Isaacson   “Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”—The New York Review of Books

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back


Elisabeth Rosenthal - 2017
    In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?Breaking down this monolithic business into the individual industries--the hospitals, doctors, insurance companies, and drug manufacturers--that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw.The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

Money-Driven Medicine: The Real Reason Health Care Costs So Much


Maggie Mahar - 2006
    But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good.Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced.How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs.In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less.In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.

Redefining Health Care: Creating Value-based Competition on Results


Michael E. Porter - 2006
    health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums—not to mention the stability of state and federal government budgets.In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying—and largely overlooked—causes of the problem, and provide a powerful prescription for change.The authors argue that competition currently takes place at the wrong level—among health plans, networks, and hospitals—rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Participants in the system accumulate bargaining power and shift costs in a zero-sum competition, rather than creating value for patients. Based on an exhaustive study of the U.S. health care system, Redefining Health Care lays out a breakthrough framework for redefining the way competition in health care delivery takes place—and unleashing stunning improvements in quality and efficiency.With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move health care toward positive-sum competition that delivers lasting benefits for all.

Critical: What We Can Do About the Health-Care Crisis


Tom Daschle - 2008
     Undoubtedly, the biggest domestic policy issue in the coming years will be America’s health-care system. Millions of Americans go without medical care because they can’t afford it, and many others are mired in debt because they can’t pay their medical bills. It’s hard to think of another public policy problem that has lingered unaddressed for so long. Why have we failed to solve a problem that is such a high priority for so many citizens? Former Senate Majority Leader Tom Daschle believes the problem is rooted in the complexity of the health-care issue and the power of the interest groups—doctors, hospitals, insurers, drug companies, researchers, patient advocates—that have a direct stake in it. Rather than simply pointing out the major flaws and placing blame, Daschle offers key solutions and creates a blueprint for solving the crisis. Daschle’s solution lies in the Federal Reserve Board, which has overseen the equally complicated financial system with great success. A Fed-like health board would offer a public framework within which a private health-care system can operate more effectively and efficiently—insulated from political pressure yet accountable to elected officials and the American people. Daschle argues that this independent board would create a single standard of care and exert tremendous influence on every other provider and payer, even those in the private sector. After decades of failed incremental measures, the American health-care system remains fundamentally broken and requires a comprehensive fix. With his bold and forward-looking plan, Daschle points us to the solution.

The Cost Disease: Why Computers Get Cheaper and Health Care Doesn't


William J. Baumol - 2012
    Similarly, the upward spiral of college tuition fees is cause for serious concern. In this concise and illuminating book, the well-known economist William J. Baumol explores the causes of these seemingly intractable problems and offers a surprisingly simple explanation. Baumol identifies the "cost disease" as a major source of rapidly rising costs in service sectors of the economy. Once we understand that disease, he explains, effective responses become apparent.Baumol presents his analysis with characteristic clarity, tracing the fast-rising prices of health care and education in the United States and other major industrial nations, then examining the underlying causes, which have to do with the nature of providing labor-intensive services. The news is good, Baumol reassures us, because the nature of the disease is such that society will be able to afford the rising costs.

Understanding Health Policy: A Clinical Approach


Thomas Bodenheimer - 2012
    "Understanding Health Policy, 6e" makes otherwise difficult concepts easy to understand so you can make better decisions, improve outcomes, and enact positive change on a daily basis.Features:Coverage of structure, organization, and financing of the health care systemKey principles, descriptions, and concrete examples are skillfully interwoven in each chapter to make important issues interesting and understandableClinical vignettes clarify difficult concepts and demonstrate how they apply to real-world situationsComprehensive list of review questions reinforce what you have learnedUnderstanding Health Policy, 6e will help you develop a clearer, more systematic way of thinking about health care in the United States, its problems, and the alternatives for managing and solving these problems."

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


Regina Herzlinger - 2007
    health care, patients and doctors are losing. Who Killed Health Care? shows how to win the war. One of the nation's most respected health care analysts, Regina Herzlinger exposes the motives and methods of those who have crippled America's health care system-figures in the insurance, hospital, employment, governmental, and academic sectors. She proves how our current system, which is organized around payers and providers rather than the needs of its users, is dangerously eroding patient welfare and is pushing costs out of the reach of millions.Who Killed Health Care? then outlines Herzlinger's bold new plan for a consumer-driven system that will deliver affordable, high-quality care to everyone. By putting insurance money in the hands of patients, removing the middleman in the doctor-patient relationship, and giving employers cost relief, consumers and physicians will be empowered to make the system work the way it should. Herzlinger describes in precise detail how her innovative program will provideSmaller, disease-focused medical facilities that provide complete care for patientsA national system of medical records that provides privacy with confidential access by approved practitionersMandatory performance evaluations of all hospitals and all other medical organizationsMandatory health insurance with subsidies for those who cannot afford itWho Killed Health Care? is a call to arms that must be answered; the welfare of every American hangs in the balance."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

Malignant: How Bad Policy and Bad Evidence Harm People with Cancer


Vinayak K. Prasad - 2020
    Some of these drugs are truly transformative, offering major improvements in how long patients live or how they feel--but what is often missing from the popular narrative is that, far too often, these new drugs have marginal or minimal benefits. Some are even harmful. In Malignant, hematologist-oncologist Dr. Vinayak K. Prasad writes about the many sobering examples of how patients are too often failed by cancer policy and by how oncology is practiced. Throughout this work, Prasad illuminates deceptive practices which- promote novel cancer therapies long before credible data are available to support such treatment; and- exaggerate the potential benefits of new therapies, many of which cost thousands and in some cases hundreds of thousands of dollars.Prasad then critiques the financial conflicts of interest that pervade the oncology field, the pharmaceutical industry, and the US Food and Drug administration.This is a book about how the actions of human beings--our policies, our standards of evidence, and our drug regulation--incentivize the pursuit of marginal or unproven therapies at lofty and unsustainable prices. Prasad takes us through how cancer trials are conducted, how drugs come to market, and how pricing decisions are made, asking how we can ensure that more cancer drugs deliver both greater benefit and a lower price. Ultimately, Prasad says,- more cancer clinical trials should measure outcomes that actually matter to people with cancer;- patients on those trials should look more like actual global citizens;- we need drug regulators to raise, not perpetually lower, the bar for approval; and- we need unbiased patient advocates and experts.This well-written, opinionated, and engaging book explains what we can do differently to make serious and sustained progress against cancer--and how we can avoid repeating the policy and practice mistakes of the past.

Pathologies of Power: Health, Human Rights and the New War on the Poor


Paul Farmer - 2003
    Paul Farmer, a physician and anthropologist with twenty years of experience working in Haiti, Peru, and Russia, argues that promoting the social and economic rights of the world’s poor is the most important human rights struggle of our times. With passionate eyewitness accounts from the prisons of Russia and the beleaguered villages of Haiti and Chiapas, this book links the lived experiences of individual victims to a broader analysis of structural violence. Farmer challenges conventional thinking within human rights circles and exposes the relationships between political and economic injustice, on one hand, and the suffering and illness of the powerless, on the other.Farmer shows that the same social forces that give rise to epidemic diseases such as HIV and tuberculosis also sculpt risk for human rights violations. He illustrates the ways that racism and gender inequality in the United States are embodied as disease and death. Yet this book is far from a hopeless inventory of abuse. Farmer’s disturbing examples are linked to a guarded optimism that new medical and social technologies will develop in tandem with a more informed sense of social justice. Otherwise, he concludes, we will be guilty of managing social inequality rather than addressing structural violence. Farmer’s urgent plea to think about human rights in the context of global public health and to consider critical issues of quality and access for the world’s poor should be of fundamental concern to a world characterized by the bizarre proximity of surfeit and suffering.

Best Care Anywhere: Why VA Health Care Is Better Than Yours


Phillip Longman - 2007
    This encouraging change not only has benefited veterans but also provides a blueprint for salvaging America's own deeply troubled healthcare system. "Best Care Anywhere" shows how a government bureaucracy, working with little notice, is setting the standard for best practices and cost reduction while the private sector is lagging in both areas. Author Phillip Longman challenges conventional wisdom by explaining exactly how market forces work to lower quality and raise prices in the healthcare sector, and how U.S. medical practices have a weak basis in science. The book, expanded from a widely praised article in the "Washington Monthly," mixes hard facts with author Philip Longmans' compelling human story of the loss of his wife to cancer. Part manifesto, part moving memoir, "Best Care Anywhere" offers new hope for addressing a major problem of contemporary society that affects all of us.

Priced Out: The Economic and Ethical Costs of American Health Care


Uwe Reinhardt - 2019
    Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.The problem, Reinhardt says, is not one of economics but of social ethics. There is no American political consensus on a fundamental question other countries settled long ago: to what extent should we be our brothers' and sisters' keepers when it comes to health care? Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America finances health care, and he offers a penetrating ethical analysis of recent reform proposals. At this point, he argues, the United States appears to have three stark choices: the government can make the rich help pay for the health care of the poor, ration care by income, or control costs. Reinhardt proposes an alternative path: that by age 26 all Americans must choose either to join an insurance arrangement with community-rated premiums, or take a chance on being uninsured or relying on a health insurance market that charges premiums based on health status.An incisive look at the American health care system, Priced Out dispels the confusion, ignorance, myths, and misinformation that hinder effective reform.