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America's Health Care Crisis Solved: Money-Saving Solutions, Coverage for Everyone

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This book is written by Dan Perrin and Pat Rooney. Pat has been called both "the father of Medical Savings Accounts" and "the father of school choice." He's a well known maverick who comes up with ideas that seem incredibly radical, and after they are adopted, everyone thinks "Well, that was obvious." Well it's not when Pat first thinks of it.

If you only read one chapter, read chapter 5. In it they outline a plan for the government to pay for health insurance for everyone who doesn't already have government sponsored insurance with a tax credit. This isn't the typical "let's spend more of the taxpayers money because it's free." They want to pay for it by discontinuing the tax givebacks which in 2008 are estimated to be $260 billion.

The three things that make it work are:
1. It is refundable - you don't have to owe taxes to get the money.
2. It's advanceable - you don't have to wait for their tax refund to get the money.
3. It's assignable - the government can pay it directly to the insurance company.

I'm an herbalist and a naturopath, so I prefer that people exercise, eat right, take their vitamins, minerals and herbs and stay out of the doctor's office and the hospital. But there is a time and a place for western medicine. It is so expensive that you do need health insurance in case something catastrophic happens. In this book they are recommending that the government pay:
* $5,000 a year for a family.
* $2,000 a year for an individual.

This is the most logical plan I have heard. I would much prefer this to the nationalized healthcare that is seen in other countries where they ration healthcare because of budget constraints.

America's Health Care Crisis Solved: Money-Saving Solutions, Coverage for Everyone is very rare book. Unlike many others on the subject it is very easy to read, very easy to understand and very hard not to believe in. It goes to the root of the well-known domestic problem and hits the nail right on its head. The authors were writing this "compact" book with their lives. Legendary civil-rights champion Pat Rooney and known inside the beltway "locomotive" - Dan Perrin, dedicated their lives to do something decent and worthy in most not-transparent business in the US - murky health insurance world. They brought in "fair-care" approach,. They unmasked the hospitals "Wonderland" world where consumer's dollar devaluates and fluctuates in accordance with woodoo practices of the greedy managements.

Because of their sustained support and dedication the long legislative struggle finally gave birth to most appealing and sound healthcare product of the new century - Health Saving Accounts - HSAs. But what is their more important achievement is, that they did their best to unlock insurance best secret kept Pandora box and clear the way for further conservative healthcare innovations which so far is known by the term - Consumer Driven Health Care.

This laconic, as only the truth could be, book is a must-to-read book for healthcare crowd and bankers, politicians and everyone who is not indifferent to challenging future vis-à-vis most painful domestic problem. Unfortunately, like almost everything in our global world, healthcare crisis is also global. It is not exaggeration to say that there is no country on the face of the earth whose healthcare system is not in crisis. (I do not mean the very poor countries - they do not have healthcare at all). Great Britain calculated that if no changes made in couple of decades their GNP will be not enough to cover healthcare cost. Same problem in famous for its free healthcare - Canada, European countries and other's in developed world.

America remains the only super-power not because we produce more say, sneakers, but because we produce more technologies second to none. America's Health Care Crisis Solved unleashes innovative creativity not only domestically. Other countries working to solve their problems always were looking at us. And this book is a good beacon in eternal struggle - individualism and freedom vs. collectivism and so called equality. Strangely enough, let's admit, that this struggle is most pronounced here in the United States. Ironically, Hilary-care phenomenon could not even exist in former Soviet bloc countries. Because they do not want to hear about variations of governmentally managed "free" healthcare systems. They are sick of it, they've lived under it. No wonder countries like Poland, Czech Republic, Kazakhstan and others are in a process of adopting consumer driven healthcare approach including medical saving accounts.

For them America is still a beacon, and therefore for me authors of America's Health Care Crisis Solved are Great Americans, indeed.

TG - former recipient of Soviet "free healthcare"

Why does the government only create shortages and surpluses? The answer is quite simple: by subsidizing producers, the government gives producers an incentive to increase supply above actual demand, creating a surplus, and, by subsidizing consumers (including health care consumers), the government gives consumers an incentive to increase demand above the actual supply, creating a shortage, or, in the case of our health care system, a crisis.

This book outlines a plan to give consumers an incentive to reduce their demand while assuring themselves of proper health care. This book is brilliant in its simplicity.

I just got this book and found it to be very helpful. I've spent a lot of time and effort researching health care and the different options but i keep finding two problems:

1) Nothing makes clear sense and much of the book it is above my head
2) The answer is usually politically charged

I found that unlike the other books I read, this one was very easy to understand and the argument was very balanced. I have to say I highly recommend it.

Everywhere I turn, everyone's talking about the health care problem but no one ever offers any viable solutions.

Well, after reading this book, that's changed. The authors actually present a solution that resonates with your mind, as well as with your conscience. A fair & reasonable approach, I think it would be a disservice to not read it.

Too often, policymakers on the right cede ground when it comes to health care.

Not Pat Rooney and Dan Perrin.

There is a free market solution to health care. It starts with health savings accounts (HSAs), but doesn't end there. Interstate purchase of health insurance plans. Account-based Medicare and Medicaid. Making doctor and hospital prices at least as transparent as drug prices. High risk pools. Skilled nursing facilities. Wellness care.

It's all there. If you're looking for a good answer to HillaryCare 2.0 and SnObama-care, read this book.

This is a very informative review of the contributing factors driving up health care costs and several doable recommendations. It makes it clear that continuing down our current path will only lead to the collapse of our health care system and our economy. It also has specific things to do if you are caught in crushing health care costs. You'll become aware of how little the political retoric totally confuses the issues and provides no solutions.

I see now where Senator McCain and his team got their ideas that they proposed during his presidential campaign!!

In the first couple of chapters, the authors make very valid points: the uninsured not only get no discount from hospitals, they're often socked with huge bills. Can the government put a stop to this? Yes, by providing everyone in need of insurance with a high deductible health insurance to start, and then start cutting the deductible as our deficit budget allows. ($2500 comes to mind as a starting number to avoid catastrophic bills)

I tried to shop with Blue Cross for an HSA (Health Savings Account) and the savings were miniscule and not worth the hassle. Looks like BC is not too keen to promote HSAs to their existing members who pay nice fat premiums anyhow.

This book would remove employers' tax deduction, in order to give the deduction to individuals. I see no big advantage in that; besides, there's the huge disadvantage that individuals have: they're at the mercy of the insurance companies. Unless the government arranges pools of the insured who then have collective bargaining. Senator McCain's plan was unsure as to how to force insurance companies into accepting people with pre-existing problems.

Lastly, until people treat their insurance benefits as their own money, we won't get anywhere. As long as insurance pays, people want it all, and won't bat an eyelash at the expense of even a $1000 scan for a headache, as long as someone else is paying. Will HSAs help in this regard? Somehow, I doubt it...when it comes to health, people seem to perceive that more is better. Even in countries like India where people pay cash for everything in health care, this attitude prevails. Sadly, even insurance companies are struggling to stop needless tests, not really succeeding.

Bottom line is: in choosing Obama, the people have voted democrat vs the republican health care approach that this book represents. Only time will tell whether we'll have effective health care for all.

If you are concerned about the future of our nation's health care system, you must read this book! Rooney and Perrin have provided easy-to-understand, common-sense solutions in a health care book that is actually a fast read. No PhD needed. Just an open mind.

"America's Health Care Crisis Solved" gets one (and only one) thing right - that hospitals charge the uninsured outrageous prices, as much as 6X those charged Medicare! Just reducing hospital, physician, etc. prices to the levels charged Medicare (or even HMOs) would go a very, very long way towards solving the crisis.

Unfortunately, the authors go on. First they misrepresent the data on Canada and England to contend that they're spending more per patient than the U.S. Not true - the U.S. spends close to 2X per patient that of most other developed nations. A considerable amount of those savings are due to single-payer systems eliminating marketing (much directed at AVOIDING certain patients) and administrative expenses of reviewing pre-approval and claims data for compliance with complex rules (eg. not allowing non-covered expenses, assuring proper medical coding, prohibiting pre-existing conditions). McKinsey estimates eliminating excessive administrative costs of private health insurers would largely cover the cost of covering all the uninsured.

Perrin and Rooney then proceed to "argue"/imply that rising insurance benefits have CAUSED the medical care cost explosion in the U.S., ignoring the fact that government-provided health care in other nations hasn't had near the degree of problem as we have.

Then there's the problem with wide variations in health care practice first brought to light by Dr. John Wennberg. To remedy the nation's overdependence on costly, high-intensity interventions such as surgery and ICU stays, he calls for improved physician communication and greater patient involvement in medical decision making, and also cites are reimbursement for procedures, rather than quality, as part of the problem. Recent data from California, for example, found some California hospitals spend as much as four times more than others to care for patients with similar chronic illnesses, with no gain in quality or patient satisfaction. At the same time, many clinically proven treatments, ranging from beta blockers for heart disease to antibiotics following surgery, are consistently underused. "The irony is that most of these proven interventions don't cost that much."

Another Wennberg finding was that supply is more important than had been realized - eg. a greater supply of hospital beds and specialists led to their being used more. This finding is why most HMOs use primary-care "gatekeepers" to limit use of specialists - contrary to the author's advice. If every Medicare provider in the country spent at the same rate as the lowest 10% of providers in the program, overall costs would be slashed by 30%.

Other physician leaders such as quality improvement expert Dr. Donald Berwick have concluded that as much as 50% of health care is unneeded if standards of care were more widely developed and adhered to.

As for the authors' approach to saving on Medicare drug costs, they "forget" to mention that Congress prohibited negotiation or price dictation to lower those prices. Approximately 50% could be saved, using actual results from V.A. and Medicaid dictated price programs.

Michael Porter, Harvard guru on competition, has concluded that the American model focuses far too much on cost-reduction, increasing negotiating power, providing broad-lines of service, and cost-shifting, and instead should focus on long-term value (results vs. costs) for patients. Key to improving, he says, is the gathering of long-term data on outcomes.

Dr. Arnold Relman, Professor Emeritus at the Harvard Medical School and former long-time editor of the New England Journal of Medicine, has concluded that for-profit entities are part of the problem. A 1997 study covering all acute-care hospitals found total hospital expenses/admission 10% higher in for-profits (administrative costs were 34% of the total, vs. 25% for non-profits; however, the for-profits provided less in-house clinical personnel. Thus, it is also not surprising that a 2002 study pooling all published data found the risk of patient death 2% higher in the for-profit hospitals. Similarly, a 1999 published study of dialysis units found mortality rates 20% higher in for-profits, as well as the likelihood of being placed on a transplantation list 26% lower (would end the center's revenues). Prior studies also found lower expenditures on care within the for-profits. Most nursing home payments are from standardized, per-diem Medicaid rates. A 1998 survey found for-profits with 40% more serious care violations than non-profits. Investor-owned insurance plans take 10-25% of premiums, vs. 5-10% for non-profits and only 3% for Medicare.

Still other medical experts attest to how for-profit drug companies have driven up costs (and sometimes harmed patients) through misrepresentations, poor testing, and political power. McKinsey estimates that paying what the rest of the world pays for drugs and medical devices would by itself more or less pay the cost of covering the uninsured.

Finally, proposing HSAs as a cure-all for health costs is silly. Those earning close to Federal poverty levels cannot afford such savings, nor do they qualify for Medicaid. (The authors' claim that the "poor quality for Medicaid" is false - eg. a single person earning $362/month or $4,344/year is ineligible in Arizona unless they have offsetting medical expenses.)