Who Killed Healthcare?: America's $2 Trillion Medical Problem - And the Consumer-Driven Cure: America's $1.5 Trillion Dollar Medical Problem--And the

I have read your book and have gained a whole perspective on health care. I myself have been caught in the maze of being uninsured, under insured, on medicaid in my lifetime. I raised (still contributing) 3 daughters 2 of which have chronic medical conditions. My son passed away at 6 and half years of age from the same illness that has kept us in the maze! For the longest time I believed in the concept of "Universal Health care." People in crisis will grab hold of whatever they can. Too many times we see people make job choices not based on talent, ability or a desire to improve themselves based on an insurance plan. I know this all too well! It saddens me that we are bound in this country to the current situation based on financial fear! I am increasingly becoming of a different mindset. I believe more now than ever that choice, and the opportunity to benefit from those choices need to be the driving force in the development of a consumer driven health care system. I have had the opportunity to talk to many people coming from many different perspectives on this issue. It is troubling and there are solutions. I was amazed at how much we are all in the dark. Your book sheds a much needed light on the situation. I referred as many people as I could toward your work. I quote you, ""Insurance costs are so high that we have over 46 million people who go without it, which is a shameful scar on the richest country in the world...to add insult to injury, we receive far too little health care for all this money." We agree, I agree, It is a unjust, unfair and it is time to do something about it! The concept that the uninsured are actually charged a higher rate needs to be focused on as well, and as I continue on this crusade to educate, empower and advocate for the uninsured, I will continue to educate myself. We need to end the disparity found in our medical system, and there is no need for any more people like you reference in your book, (J, Morgan). I highly recommend this book!

Dr Herzlinger tells the truth,no spin,no politics,just pure honesty that is actually patriotic at its core. Having recommended her book to several dozen medical group practice administrators,they all are in agreement with her thoughts and that's a first.This is a must read for every medical group practice administrator,physician and small business owner.

According to information released by the Centers for Disease Control and Prevention on June 24, 2007, about 43.6 million people in the United States, or 14.8 percent of the population, had no health insurance in 2006. The finding, based on a survey of 100,000 people, is lower than previous federal estimates of 46 million. The estimate is based on those who did not have insurance at the time of the interview. About 54.5 million people in the country, or 18.6 percent of the population, had no insurance for at least part of 2006. Whatever the exact numbers, there is obviously a very serious problem with health care provision in the U.S. In fact, dozens. In her previously published book, Consumer-Driven Health Care, Regina Herzlinger explains that consumer-driven health care 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. Herzlinger wrote the first, "Why We Need Consumer-Driven Health Care," then edited the contributions by others that 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. In this volume, Herzlinger focuses her attention on what she describes as "America's $2 trillion medical problem" (about the current size of the economy in China) and explains why consumer-driven initiatives offer a "cure." More specifically, she exposes "the iron triangle" of third parties (i.e. Congress, health insurers, and hospital administrators) that have opposed consumer-driven health care and thereby subordinated, if not totally ignored the welfare of patients as well as their personal physicians (if they have any). These third-parties are the ones who have "killed" health care for tens of millions of uninsured or under-insured people who, Herzlinger insists, have been deprived of power, information, and choice. She is a passionate and well-informed advocate of nothing less than major, extensive, and comprehensive health care reform. "Four armies are battling to gain control [of health ca

Herzlinger begins by telling us that she was spurred to write this book after a tax exempt hospital chain (Sioux Valley Hospitals and Health Systems) testified before Congress of the "need" to limit competition from specialty hospitals - "would undermine it's ability to provide care to the uninsured." Unfortunately, the effort was successful in achieving a moratorium, even though the system only provided $5 million (at overstated prices) prior to the moratorium, and then cut that to $3 million afterwards. (A 2004 congressional comparison of non-profits and for-profits concluded that non-profits, on average, provided only 0.6% greater uncompensated care.) Since 2000, health insurance premiums have risen 73%, vs. inflation and wages increasing 15%. Herzlinger blames: 1) hospital consolidations (# dropped 20% from 1970-2005) - usually without cost rationalization of duplicated costs, aimed simply at reducing the number of competitors. In addition, hospitals have attempted to further reduce competition by buying physician practices. 2)Bureaucratic HMOs and insurance companies, along with their high-priced CEOs. 3)Government: States sometimes limit the number of insurers and the variation in their offerings; meanwhile, the federal government meddles by providing incentives for certain treatment modes Herzlinger's Recommendations: 1)Provide tax-free grants, adjusted to reflect an individuals' health status (eg. a 55-year-old male with diabetes would be given the average cost of treating such an individual). The individual would be free to save whatever was not spent - would not need to be spent in that year, though could only be spent on health care. Individuals would have to sign up with a provider for a 5-year period - thus allowing providers an incentive for preventive and/or front-end investments such as a transplant. (Providers would be given an "out" for non-compliant patients, and patients likewise for totally non-responsive providers.) 2)Require audited price and outcome data to be published. (This would quickly bring about an increase in smaller, focused-care medical facilities and a major impact - the top five major diseases account for 49% of all costs.) 3)Require the establishment and use of an integrated computer medical record system. (This would reduce duplicated tests and prescription errors due to poor handwriting, as well as catch inappropriate prescriptions.) The potential "fly in the ointment" here is that Herzlinger's approach to severity adjustment would effectively discriminate between sicker and less-sick patients. In her defense, she offers several examples where this has been tried. Hopefully she is correct - if not, the approach may instead need to be based on measures of compliance with standards of care established by experts (though disliked by Herzlinger).