Consumer-Driven Health Care: Implications for Providers, Payers, and Policy-Makers

Although this book was written a few years ago, the issues addressed in it by Regina Herzlinger and other contributors seem even more relevant - indeed, more urgent - now than they were in 2004. How does Herzlinger characterize consumer-driven health care? It is "fundamentally about empowering health care consumers - all of us - with control, choice, and information." Such control will "reward innovative insurers and providers for creating the higher-quality, lower-cost services we want and deserve." What would be the role of government? She asserts that "government will protect us with financial assistance and oversight, not micromanagement." The material in this substantial volume is organized within five Parts. Herzlkinger wrote the first, "Why We Need Consumer-Driven Health Care," then edited the contributions by others which comprise Parts Two-Five. She also wrote Chapter 78, "A Health Care SEC: The Truth, the Whole Truth, and Nothing But the Truth." For most of us who are not health care professionals, this volume provides about as much information as we could possibly need, much less process. I especially appreciate the fact that Herzlinger and her associate contributors make a conscious effort to avoid jargon, vague theories, oblique hypotheses, etc. They obviously believe that major health care issues are too important to be packaged as flimflam, swamp gas, and flapdoodle. Hence their rigorous focus on explaining (from a variety of perspectives) why consumer-driven health care is needed, and, how to establish and then sustain it. Of special interest to me were these chapters whose titles correctly indicated what their respective authors discuss: Chapter 5, "Health Care Productivity," Herzlinger Chapter 20, "An Insurance CEO's Perspective on Consumer-Driven Health Care," Leonard D. Schaeffer (Chairman and CEO, WellPoint Health Networks) Chapter 25, "Challenges of Consumer-Driven Health Care," Eugene D. Hill III Chapter 34, "The Role of Information: J.D. Power's Paradigm Lessons from the Automotive Industry," J.D. Power III Chapter 52, "Consumer-Driven Health Care: Management Matters," Richard M.J. Bohmer, Amy C. Edmondson, and Gary P. Pisano Given the fact that this volume offers a total of 81 chapters, my guess is that each reader will find at least 10-15 of special interest to her or him. I presume to suggest, also, that many of those subjects which may seem to be of least interest and value will, in fact, generously reward a careful reading. It remains for each reader to review the Contents and then decide what to read and in which sequence. Those who share my high regard for this volume are urged to check out Michael Porter and Elizabeth Olmsted Teisberg's Redefining Health Care: Creating Value-Based Competition, and two books by Lawton Robert Burns and his Wharton associates: The Health Care Value Chain: Producers, Purchasers, and Providers, and, The Business of Healthcare Innovation.

Sub-Title: Implications for Providers, Players, and Policy-Makers --,Citizen participation, Consumer satisfaction, Evaluation, Health & Fitness, Health Care Administration, Health Care Delivery, Health Care Issues, Health Policy, Health planning, Health/Fitness, Medical / Nursing, Patient Compliance, Patient satisfaction, Health systems & services, Medical / Administration, Personal & public health, Medical ==If your interests or profession lies in any area of health care this is a book that you almost have to have. In its almost 1,000 pages nearly every aspect of health care coverage is discussed. The format of the book includes some 200 pages written by Professor Herslinger followed by some 72 articles written by some 93 participants in a conference she held. As you would expect, the quality of the papers vary greatly. ==There are also a few reasons to disagree with some of Professor Herslingers basic thesis. She seems to believe that health insurers would compete in a fair market place to provide care to anyone. This is simply not true. If an insurance company can pre-select to eliminate giving any coverage at all to the sicker or more risky patients, it is to their benefit. An AIDS patient, with a requirement for expensive drugs can be folded into the coverage written for a large group, but an individual policy would have to be very expensive, or simply not written at all. The coverage of such patients is covered with what I think are unrealistic assumptions. ==The book presents a series of views that are just a bit simplistic, but which are forming a part of the national debate on health care. The information is needed if only to be aware of the discussion.