social legislation. The new law extends health insurance to nearly all Americans, fulfilling a century-long quest and bringing the United States to parity with other industrial nations. Affordable Care aims to control rapidly rising health care costs and promises to make the United States more equal, reversing four decades of rising disparities between the very rich and everyone else. Millions of people of modest means will gain new benefits and protections from insurance company abuses - and the tab will be paid by privileged corporations and the very rich.How did such a bold reform effort pass in a polity wracked by partisan divisions and intense lobbying by special interests? What does Affordable Care mean - and what comes next? In Health Care Reform and American Politics: What Everyone Needs to Know, Lawrence R. Jacobs and Theda Skocpol--two of the nation's leading experts on politics and health care policy--provide a concise and accessible overview. They explain the political battles of 2009 and 2010, highlighting White House strategies, the deals Democrats cut with interest groups, and the impact of agitation by Tea Partiers and progressives. Jacobs and Skocpol spell out what the new law can do for everyday Americans, what it will cost, and who will pay. Above all, they explain what comes next, as critical yet often behind-the-scenes battles rage over implementing reform nationally and in the fifty states. Affordable Care might end up being weakened. But, like Social Security and Medicare, it could also gain strength and popularity as the majority of Americans learn what it can do for them.

    Ezekiel J. Emanuel looks at individual physician practices and organizations who are already successfully driving change, and the specific practices they have instituted. They are not the titans everyone seems to know and assume to be the "best"; instead, Emanuel has chosen a select group -- from small physician offices to large multi-specialty group practices, accountable care organizations, and even for-profit companies--that are genuinely transforming care.Prescription for the Future shines a bright diagnostic light on the state of American healthcare and provides invaluable insights for healthcare workers, investors, and patients. The book gives all of us the tools to recognize the places that will deliver high-quality, effective care when we need it.

    Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestselling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting. Over the last ten years, neither error rates nor costs have come down, despite scientific progress and efforts to curb expenses. Why?To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked. Patients need to know more of what healthcare workers know, so they can make informed choices. Accountability in healthcare would expose dangerous doctors, reward good performance, and force positive change nationally, using the power of the free market. Unaccountable is a powerful, no-nonsense, non-partisan diagnosis for healing our hospitals and reforming our broken healthcare system.

    Our health care is staggeringly expensive, yet one in six Americans has no health insurance. We have some of the most skilled physicians in the world, yet one hundred thousand patients die each year from medical errors. In this gripping, eye-opening book, award-winning journalist Shannon Brownlee takes readers inside the hospital to dismantle some of our most venerated myths about American medicine. Using vivid examples of real patients and physicians, Overtreated debunks the idea that most of medicine is based in sound science, and shows how our health care system delivers huge amounts of unnecessary care that is not only expensive and wasteful but can actually imperil the health of patients.The interests of politicians and the medical-industrial complex continually trump those of patients, seducing the wealthy with unnecessary procedures and leaving the poor with haphazard access to treatment. Backward economic incentives allow patients with chronic conditions to receive ineffective care, and roll after roll of red tape undermines even the best-intentioned doctors. Tens of thousands of patients die each year from overtreatment. American medicine is in desperate need of fixing.Nevertheless, Overtreated ultimately conveys a message of hope by reframing the debate over health care reform. Americans worry about rationing--that any effort to rein in the high cost of health care will result in limited access to life-saving treatments. Covering the uninsured seems like an insurmountable problem because it will drive up costs even more. Overtreated offers a way to control costs and cover the uninsured, while simultaneously improving the quality of American medicine. Shannon Brownlee's humane, intelligent, and penetrating analysis empowers readers to avoid the perils of overtreatment, as well as pointing the way to better health care for everyone.

    Gerard, PhD, its chief learning officer, candidly describe the triumphs and stumbles of a seven-year journey to lean healthcare, an effort that continues today and that has slashed medical errors, improved patient outcomes, raised staff morale, and saved $27 million dollars in costs without layoffs. Find out:> How lean techniques of value-stream-mapping and rapid improvement events cut the average “door-to-balloon” time for heart attack patients at two hospitals from 90 minutes to 37.> What ThedaCare leaders did to replace medicine’s “shame and blame” culture with a lean culture based on continuous improvement and respect for people.> How the lean principle of “building in quality at the source” broke down divisions among medical specialties allowing teams to develop patient care plans faster.> Why traditional modern management is the single biggest impediment to lean healthcare.> How the plan-do-study-act cycle coupled with rapid improvement events cut the wait time at a robotic radiosurgery unit from 26 days to six.> How the lean concept of “one piece flow” saved time in treating ischemic stroke patients, increasing the number of patients receiving a CT scan within 25 minutes from 51% to 89%.> How senior leaders at other healthcare organizations can begin their own lean transformations using a nine-step action plan based on what ThedaCare did — and what it would do differently.Toussaint and Gerard prove that lean healthcare does not mean less care. On the Mend shows that when care is truly re-designed around patients, waste and errors are eliminated, quality improves, costs come down, and healthcare professionals have more time to spend with patients, who get even better care.

    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

    Jack Geiger, M.D., New York Times Book Review

    

    In this indispensable book, the staff of the Washington Post tells the story of health-care reform and explains what it means for the American people.In the book’s first section, the Washington Post’s reporter embedded in the White House provides a behind-the-scenes narrative of how Obama and the Democrats pushed through health-care reform in the face of nearly unanimous Republican opposition. This section traces the tortured evolution of the legislation, showing how the Senate killed the public option, how the January 2010 victory of Republican senator Scott Brown left the Democrats scrambling, and how Democratic leaders ultimately negotiated among entrenched political factions—including disillusioned Democrats—to reach a compromise.What does this final package include? The book’s second section provides an accessible summary of the legislation that Obama signed into law in March 2010. In the third section, Washington Post writers answer the most pressing questions about the health-care legislation’s immediate impact. Most importantly, how will the new bill affect individuals—small-business owners, uninsured Americans with pre-existing conditions, and twenty-somethings on their parents’ policies? This is a must-read for anyone who wants to understand how this legislation came into being and what the new health-care program means.

    You might think that this would leave us with a bleak choice— either to devote more of our national budget to health care or to make do with less of it. But there’s another path. In this provocative book, Jonathan Bush, cofounder and CEO of athenahealth, calls for a revolution in health care to give customers more choices, freedom, power, and information, and at far lower prices. With humor and a tell-it-likeit- is style, he picks up insights and ideas from his days as an ambulance driver in New Orleans, an army medic, and an entrepreneur launching a birthing start-up in San Diego. In struggling to save that dying business, Bush’s team created a software program that eventually became athenahealth, a cloud-based services company that handles electronic medical records, billing, and patient communications for more than fifty thousand medical providers nationwide. Bush calls for disruption of the status quo through new business models, new payment models, and new technologies that give patients more control of their care and enhance the physicianpatient experience. He shows how this is already happening. From birthing centers in Florida to urgent care centers in West Virginia, upstarts are disrupting health care by focusing on efficiency, innovation, and customer service. Bush offers a vision and plan for change while bringing a breakthrough perspective to the debates surrounding Obamacare. You’ll learn how: • Well-intended government regulations prop up overpriced incumbents and slow the pace of innovation. • Focused, profit-driven disrupters are chipping away at the dominance of hospitals by offering routine procedures at lower cost. • Scrappy digital start-ups are equipping providers and patients with new apps and technologies to access medical data and take control of care. • Making informed choices about the care we receive and pay for will enable a more humane and satisfying health care system to emerge. Bush’s plan calls for Americans not only to demand more from providers but also to accept more responsibility for our health, to weigh risks and make hard choices—in short, to take back control of an industry that is central to our lives and our economy.

    

    health care system is in a state of disrepair, but the rabbit hole goes deeper than even the staunchest critics may realize. In Primal Prescription, authors Doug McGuff and Robert Murphy combine their expertise in economics and medicine to offer a shocking, disturbing, and ultimately enlightening view into America’s health care system. You’ll discover the real history of what went wrong with U.S. health care and insurance, and why current efforts to clean up the mess are only making things worse.But far from leaving you feeling helpless at the dismal—and sometimes deadly—state of affairs, Primal Prescription equips you with both the knowledge to understand the health care conundrum and the tools for navigating your way out of it. McGuff and Murphy offer an evidence-based “game plan” for taking control of your own medical care, protecting yourself and your loved ones regardless of what the future holds for the rest of the nation.Whether you’re currently tangled in America’s broken health care system or simply trying to avoid its clutches, Primal Prescription is a must-have resource for taking your health into your own hands.

    Why do we mistrust people more in the UK than in Japan? Why do Americans have higher rates of teenage pregnancy than the French? What makes the Swedish thinner than the Greeks? The answer: inequality. This groundbreaking book, based on years of research, provides hard evidence to show how almost everything—-from life expectancy to depression levels, violence to illiteracy-—is affected not by how wealthy a society is, but how equal it is. Urgent, provocative and genuinely uplifting, The Spirit Level has been heralded as providing a new way of thinking about ourselves and our communities, and could change the way you see the world.

    The bill was for several hundred thousand dollars--and Medicare paid it. These circumstances left Goldhill angry and determined to understand how it was possible that world-class technology and well-trained personnel could result in such simple, inexcusable carelessness--and how a business that failed so miserably could be rewarded with full payment. Catastrophic Care is the eye-opening result. Goldhill explicates a health-care system that now costs nearly $2.5 trillion annually, bars many from treatment, provides inconsistent quality of care, offers negligible customer service, and in which an estimated 200,000 Americans die each year from errors. Above all, he exposes the fundamental fallacy of our entire system--that Medicare and insurance coverage make care cheaper and improve our health--and suggests a comprehensive new approach that could produce better results at more acceptable costs immediately by giving us, the patients, a real role in the process.

    That's more than die from motor vehicle accidents, breast cancer, or AIDS--three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems.To Err Is Human breaks the silence that has surrounded medical errors and their consequence--but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agenda--with state and local implications--for reducing medical errors and improving patient safety through the design of a safer health system.This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes.Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errors--which begs the question, "How can we learn from our mistakes?"Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care.To Err Is Human asserts that the problem is not bad people in health care--it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates--as well as patients themselves.First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine