3 of 4 customers found the following review helpful:
 Health Care Financing, 2004-03-31
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.
6 of 6 customers found the following review helpful:
 Frustrated with the current world of health care? Read on.., 2004-03-09
Health policy is often very intimidating to people without specific expertise. This is a shame because it affects each and every one of us. Former Colorado Governor Richard Lamm has written a concise, easy-to-read book that every thoughtful American should read - and then act upon. Lamm takes his readers on journey through the American health care system. With the clarity of vision available to a former politician, Lamm takes on many of the myths of our health care system: 1) that it is not the best health care system in the world, by almost any measuring device ("a nation may have brilliant medicine but have a poor or inadequate health care system"); 2) that Social Security and Medicare have a ponzi scheme quality to them that will bankrupt future generations; 3) that the physician-patient relationship should not determine the course of health care in this country. Lamm argues passionately for a more rational public policy with respect to health care - one that seeks to maximize the health of the public rather than maximize the health of each and every individual. Public policy must stand up for the collective good, even if at the expense of additional marginal health care provided to any given individual. He presses his readers to recognize that the question should be "how does a society produce health?" and that the answer is that the health care delivery system is only a part of the health agenda. The quest for a healthier society may be "best achieved in areas of social policy other than health care." The solution lies in explicitly recognizing the role that rationing must play in a more effective and equitable health care system. A central component of this is recognizing that health care should not be viewed as a right. Lamm reminds us "no matter how we organize health care and no matter how we fund health care, we will find that our ability to discover medical miracles has outpaced our ability to pay for them." A "right" trumps all other categories of social spending - including housing and education and will lead us into an ever enlarging black hole of health care spending. Better to provide basic health care to all Americans and let "rights" refer to the freedom of those with more resources to pay for marginal, but expensive care. Although Lamm's discussion of what ails the system and the need to change its fundamental dynamics are the most well reasoned and articulate aspects of the book, he does spend some time focusing on the details of how to fix the system on a more practical level. Lamm argues that fixing the system will require removing the obstacles that keep market dynamics from working. This means "structuring incentives for both the providers and purchasers to improve productivity." Rather than rely on government controls, the government should focus on market reform a la managed competition. Lamm also proposes some fundamental changes to Medicare and Social Security, as well as malpractice reform and medical personnel changes. The book reminds us just how broken our public policy is with respect to health care, but also sheds important light on what we must be willing to do to realign our public policy to create a more equitable, sustainable American health care system. This book should be required reading for every person who has ever griped about our health care system, worried about our health care system, been bankrupted by our health care system, or, in fact, used our health care system.
2 of 2 customers found the following review helpful:
Facing up to difficult decisions, 2004-02-29
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.
3 of 3 customers found the following review helpful:
Reality of US healthcare exposed, 2004-02-24
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.
|
Amazon Sales Rank:#654940