Health Care Will Not Reform Itself: A User's Guide to Refocusing and Reforming American Health Care |  | Author: George C. Halvorson
Publisher: Productivity Press
Category: Book
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Media: Hardcover
Edition: 1
Pages: 184
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Dimensions (in): 9 x 6.1 x 0.7
ISBN: 143981614X
Dewey Decimal Number: 362.104250973
EAN: 9781439816141
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Product Description
Health care reform is within our reach. According to George Halvorson, CEO of the nation's largest private health care plan, only by improving the intent, quality, and reach of services will we achieve a health system that is economically feasible into the future. This year, Americans will spend 2.5 trillion for health services that are poorly coordinated, inconsistent, and most typically focused on the belated care of chronic conditions. What we have to show for that expenditure is a nation that continues to become more obese, less healthy, and more depressed. In Health Care Will Not Reform Itself, Kaiser Permanente CEO George Halvorson proves beyond a doubt that the tragically inconsistent care that currently defines the state of U.S. health services is irresponsible, irrational, but more importantly, fixable. With detail that might shock you, he shows why the nonsystem we now use is failing. Then, applying the same sensible leadership that makes Kaiser the most progressive health care organization in the world, he answers President Obama’s mandate for reform with a profound incentive-based, system-supported, goal-focused, care-improvement plan. Halvorson draws from respected studies, including his own, and the examples of successful systems across the world to show that while good health care is expensive, it is nowhere near as costly as bad health care. To immediately curb care costs and bring us in line with President Obama's projected parameters, he recommends that we: - Take a preventive approach to the chronic conditions that account for the lion’s share of medical costs
- Coordinate patient care through a full commitment to information technology
- Increase the pool of contributors by mandating universal insurance
- Rearrange priorities by making health maintenance profitable
- Convene a national committee to "figure out the right thing" and "make it easy to do"
While this book offers sage advice to policy makers, it is also written to educate the 260 million stakeholders and invite their participation in the debate that is now shaping. What makes this plan so easy to understand and so compelling is that it never strays from a profound truth: that the best health system is one that actually focuses on good health for everyone. All royalties from the sale of this book go to Oakland Community Voices: Healthcare for the Underserved
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Showing reviews 1-5 of 15
 Solid Overview on ways to reduce American health care costs September 1, 2009
George Fulmore (Concord, California USA)
5 out of 6 found this review helpful
With all the current interest in health care reform, I found this an excellent book to provide hope and background for those of us who favor health care reform under President Obama. Written by the current CEO of Kaiser Permanente, the book systematically provides areas where cost-savings can be achieved in an easy-to-read-and-follow format.
His first and, perhaps, most important suggestion, is, to me, a blockbuster. Per Halvorson, if we get everyone in our country insured, this, by itself, should reduce the average annual cost of health care insurance to a family of four by about $1,200. (The average cost to a family, he tells us, is now about $12,000 per year.) This cost reduction, if it could be sold to more folks in the current health care reform debate, could, of course, be a very strong argument in favor of the "public option." But Halvorson does not really tell us exactly where this savings would come from. He infers that it would be in the insurance company premium, itself. But the book is embarrassingly short on much of any criticism of insurance companies, their CEO salaries, their profits and administrative costs, etc. It is one of the flaws of the book, for sure. Perhaps the only flaw.
The strength of the book, again, is to give us hope that overall health care costs can, over time, be reduced and controlled. To get another $1,300 annual reduction, on top of the $1,200 above, he says "We need to reduce the costs of care by improving care." Among his suggestions for this are:
* Focus on the conditions that cost the most within the chronic conditions
* Reduce the number of doctors, now averaging 17, for patients with multiple chronic conditions
* Decrease the number of medication errors and post-operation infections
* Improve the "linkage" among doctors, especially the specialists, and, especially, when one patient has multiple specialists
* Reduce the payments to specialists, relative to those for primary care doctors
* Provide financial incentives for prevention of sickness and disease
* Build strategies for containing costs of age-related conditions via evidence-based methodology
As the CEO for Kaiser, Halvorson cites his organization as benefitting from its "vertical integration," which ensures that doctors with different specialties work effectively together. He also raves about Kaiser's Electronic Medical Records system, which is the result of a $4 billion data processing effort that "is probably the biggest single business systems project ever done in any industry anywhere in the world."
Halvorson thinks that we need universal care in our country. As part of his push for it, he tells us we need the "Double Mandate:" First, everyone must buy coverage, and, second, every private plan must sell coverage to anyone who applies. The question that leaps out at this point, of course, is why Kaiser does not immediately announce that it was complying with the second mandate? He goes on to tell us that "risk screening" is only implemented on about 5% of those who seek insurance, and that none of those are within employer-provided group plans. He says that the health care industry should be happy to welcome into existing insurance pools the 5% of folks now being denied individual insurance plans. O.K., Kaiser, how about starting this off first? Seems easy enough.
Also, Halverson at this point does not mention that all the other developed countries add another mandate, that of government oversight and control of the costs of drugs, procedures and services. Later, he calls for a National Commission on Health Care Costs, but he stops short from suggesting that it should have direct controls over the components of health care costs.
Near the end of the book, he tells us that "Premiums are always based on the average cost of care." I don't buy it. He obviously avoids any discussion about profits by insurance companies, including Kaiser, which apparently, as a not-for-profit, rakes in about $2 billion in a good year for its deferred earnings. And, later, he says, "we need to look at every category of spending - fees, hospital costs, drug costs, imaging costs, new technology costs, etc." Conspicuous by their absence are insurance company overhead costs, overblown CEO salaries - not necessarily at Kaiser -- and profits that go to shareholders or deferred earnings.
Says Halvorson, "Health care in America is comprised of hundreds of thousands of unrelated, unlinked, financially self-contained, self-focused, and self-optimizing business entities that are each set up to generate revenue and create financial success for themselves..." That sounds like an industry with opportunities to reduce costs and to, at the same time, improve its value to consumers.
Again, I recommend the book for those looking for more information on how the American health care industry can be reformed for the "public good."
Insightful, Simple, Brilliant July 7, 2009
Christov (Minneapolis, MN)
10 out of 14 found this review helpful
Mr. Halvorson succeeds yet again. In this 4th book of his healthcare trilogy, Mr. Halvorson presents the problems of our current healthcare system and prescribes simple and highly effective remedies in layman's terms. This is a great book for people who don't know much about healthcare reform and for those people who think they have all the answers. It shows that we need universal coverage (not necessarily from a single payer system), vertically integrated health IT, better communication, patient centered service, and we need to instill a healthier American culture. Great book, Mr. Halvorson. I highly recommend it.
Practical Ideas for Reducing Health Care Costs September 16, 2009
D. Richard Schmitz Jr.
1 out of 1 found this review helpful
George Halvorson is on to something here. You're never going to reduce health care costs until you improve health care quality. Providing better, proactive or preventive care reduces the severity of disease, complications, hospital stays, etc. When you provide quality care to a patient, his or her lifetime medical costs go down. When you provide poor quality care, the costs go up because the patient is sicker and needs more care. It is pretty simple when you think about it, but the current U.S. health care system does not provide incentives for doctors and hospitals to provide quality care, it only provides incentives (in the form of payments) for the volume of care they deliver.
If health care providers care about reducing costs now, there are actually steps they can take today, as Halvorson describes in chapter 3, "Set Goals and Improve Care." There are a handful of preventable medical events that are enormously expensive because of the hospital stays and expensive treatments that go with them. Picking three examples, Halvorson says we can reduce by 50 percent the number of kidney failures, asthma crises and heart attacks. With rare exceptions, no one in America should end up in an emergency room with an asthma crisis, because it is preventable through education and preventive care. At a local level, health care providers can start planning today and setting goals to reduce these incidents.
But as much as I like George's book and approach, I fear that the majority of our nation's health care providers are more concerned about their bottom line than patients like you and me.
Health Care Will Not Reform Itself July 20, 2010
ed glasser
It is a short read compared to most books on this subject. The book is crisp and focused right on all aspects of our problem with health care in the United States. The subject is handled objectively without undo spin. It also has excellent suggestions about how concerns might be resolved. It was written before the 2008 presidential elections and I still find is helpful in defining the problems objectively minus the flood of twisted tales we are still drowning in that only prevent fixes that must be made. Our present situation is not sustainable and is perceived by the rest of the developed countries in the world as being very difficult to understand what we are doing in this country.
The author has a wealth of experience beyond his present CEO position. He has been involved in the improvement of health care here and around the world for decades.
If the author will forgive me, I must mention the more recent publication of " Healing America " by T. R. Reid which to my perspective further complements "Health Care Will Not Reform Itself".
Halvorson recently spoke on this book at BEA June 7, 2009
J. Thomas (Philadelphia)
9 out of 14 found this review helpful
George Halvorson gave a fascinating podcast interview on this book last week at BEA in New York City. It's a must read for anyone who cares about the future of healthcare in this country.
Check this out...
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Showing reviews 1-5 of 15
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