Brave New World of Health Care: What Every American Needs to Know about Our Impending Health Care Crisis

Richard D. Lamm, former three-term governor of Colorado, has written a thought-provoking book, which should be required reading for any American who pays taxes or who will some day get sick. America, some of its citizens often proclaim, has the "best health care system in the world." Not so, Lamm argues: our medical miracles are parceled out to certain segments of society while forty-plus million Americans lack basic health care. Public health statistics consistently show the US lagging behind other developed countries in terms of life expectancy and infant mortality. Lamm uses the data to support his contention in this book that "The time has come to ask--and answer--some hard questions about how American health care dollars are actually being spent and about what we as a society are getting for that expenditure." Lamm should be commended for speaking forcefully and passionately on this subject. He addresses health-care rationing, allocation of public monies, the need for society to accept the inevitability of death, and the need for government to intercede in medical education (directing schools to train more primary care physicians as opposed to the preponderance of specialists we now have). The book is readable even for people unfamiliar with health care policy and economic theories. Numerous sidebars offer encapsulations of important concepts and statistics. He has a gift for explaining the conflict in easily understandable prose. He also leavens his harsh pronouncements with pithy comments, such as when he refers to former President Clinton's avowed goal of fighting all deadly diseases and writes,"What are we going to die of, rust?" His forthright voice makes one wonder how he ever got elected to public office. The author concludes with a strategy for addressing our national health care crisis. If enough people read The Brave New World of Health Care, we the people may start to find our way out of what this former governor convincingly paints as an ever-deepening moral and financial morass facing the health of our society and its citizens.

Political science and public policy blend in a serious discourse by former Colorado Governor Richard Lamm, who takes a fresh look at the current state of the American health care system in Brave New World Of Health Care. Problems in policy, professional circle, and in public attitudes and expectations alike are deftly surveyed in an engagingly thoughtful discussion of how reforms and changes may be enacted.

Anybody that is concerned about the rising costs of health care in America should read this book. As a physician, I am disappointed at the lack of leadership in medicine as well as among the politicians. We are sending the current bills for health care to our children. Gov Lamm's book provides great insight into the fiscal problems we are facing and provides some good suggestions on how we might go about addressing the problem.

Former Colorado Governor Lamm is a Democrat, but this book should be required reading for everybody, no matter where you fall on the political spectrum. It is, fortunately, a really easy read. My major problem was stopping to write down quotable lines; just about everything in this book is quotable. Did you know, for instance, that many of our problems began when Otto von Bismark declared that workers should retire at 65, an age which we are still reluctant to change? It can't have been much of an issue in 1880, when life expectancy was 47 years; but a child born today can anticipate 80 years of life. When Social Security was introduced there were perhaps 30 workers for each retired person; now there are about 3, and when the Baby Boomers begin to retire in droves at the end of this decade, we will be in real trouble, because taxes on current earners go directly to support current retirees, and it is certain that Social Security (and Medicare) will be bankrupt unless we completely reform the system; a fact cautiously alluded to recently by Alan Greenspan (and greeted by the inevitable outcries from politicians and others in support of the status quo).Lamm's theme is initially unpalatable but completely rational. He points out that our health care system is often compared favorably to Canada's: "We have the best, they come to the US for treatment." But the truth is, at its best ours may be the best, but on average, it's far from that; the World Health Organization says we're 37th out of 191 countries in terms of efficiency, what a health-care dollar buys. Canadians may have to wait longer for treatment compared to Americans, but all Canadians have coverage, and 43 million people in the US have no coverage at all. Gov. Lamm asks the hard question: Should older people (he includes himself) have the most expensive procedures, paid for by others, when there are, for example, thousands of pregnant women without access to antenatal health care? He tells the story of Oregon, where the issue of "rationing" has, uniquely, been faced. It is a far cry from the situation in the rest of the country. Our problem, in effect, is that with hot-button politics and term limits, it is too easy for us to kick our fiscal issues forward and let our children and grandchildren worry about them. In 2008, when the first Baby Boomers start watching the mail for the Social Security checks, our chickens will start coming home to roost.The book, published in paperback by the admirable Fulcrum Press of Golden, CO, is a pleasure to read, with a decent amount of ink on the page. I would have liked an index but at 128 pages it's not really necessary.

Hard choices face the American people in their thirst for more and better health care. Gov. Lamm reveals these choices and the reality of health care financing in a passionate, yet erudite fashion, supporting his arguments with appropriate data. Gov. Lamm describes the inevitable conflict between medical ethics, with its focus on the individual; and social policy, which must focus on the good of all citizens. He outlines how we arrived at our current situation of 43+ million uninsured in a system that is technologically the most advanced in the world. Since the US currently funds about 50% of all health care cost, these are issues that should concern us all. The clear message is that Americans must both understand the drivers of increased health care cost and understand that the health of the nation is not necessarily improved by more health care. The message is of particular importance to baby boomers, who will be faced with the financial reality of a shrinking working population to support their appetite for health care. This is a provocative and challenging book that should be read by anyone interested in health care and public policy.