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Critical: What We Can Do About the Health-Care Crisis Hardcover – February 19, 2008

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Editorial Reviews

From Publishers Weekly

The U.S. is the only industrialized nation that does not guarantee necessary health care to all of its citizens, and as former senator Daschle observes, Skeptics say we can't afford to cover everyone; the truth is that we can't afford not to because U.S. economic competitiveness is being impeded by the large uninsured population and fast-rising health costs. Daschle's book delineates the weaknesses of previous attempts at national health coverage, outlines the complex economic factors and medical issues affecting coverage and sets forth plans for change. Daschle proposes creating a Federal Health Board, similar to the Federal Reserve System, whose structure, functions and enforcement capability would be largely insulated from the politics and passion of the moment, in addition to a merging of employers' plans, Medicaid and Medicare with an expanded FEHBP (Federal Employee Health Benefits Program) that would cover everyone. There is no more important issue facing our country, Daschle asserts, than reform of our health-care system, and the book's health-care horror stories bring this immediacy home. (Feb. 19)
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“I may not agree with some of the political statements but Senator Daschle is right on target on the need to start a serious dialogue on health care for Americans.  His thoughtful health-care proposals will move the process forward.  Senator Daschle and I agree on the need for nonpartisanship in coming to grips with this number one domestic problem.” —Bob Dole, former Senate majority leader
“The American health-care system is in crisis, and workable solutions have been blocked for years by deeply entrenched ideological divisions. Sen. Daschle brings fresh thinking to this problem, and his Federal Reserve for Health concept holds great promise for bridging this intellectual chasm and, at long last, giving this nation the health care it deserves.” —Senator Barack Obama (IL)
 “This book provides real solutions for America’s broken health care system.” —Senator Harry Reid (NV), Senate majority leader
Critical provides answers to one of the most vexing challenges of our time.” —John Podesta, president and CEO of the Center for American Progress and a former White House chief of staff
“It is a must-read.” —Jerome H. Grossman M.D., senior fellow and director of the Health Care Delivery Project at Harvard University’s Kennedy School of Government
“Senator Daschle adds to his reputation as a clear thinker and leader. Critical shows us not only why we must solve our health care crisis but that—with political will—we can.” —Judy Feder, professor and dean at Georgetown Public Policy Institute

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Product Details

  • Hardcover: 240 pages
  • Publisher: Thomas Dunne Books; First Edition edition (February 19, 2008)
  • Language: English
  • ISBN-10: 0312383010
  • ISBN-13: 978-0312383015
  • Product Dimensions: 5.8 x 1.2 x 8.6 inches
  • Shipping Weight: 12.8 ounces (View shipping rates and policies)
  • Average Customer Review: 3.4 out of 5 stars  See all reviews (55 customer reviews)
  • Amazon Best Sellers Rank: #1,256,118 in Books (See Top 100 in Books)

More About the Author

Tom Daschle is a former U.S. Senator and Senate Majority Leader from South Dakota. He is currently a Senior Policy Advisor to the law firm of DLA Piper and a member of DLA Piper's Global Board. Daschle is a Distinguished Senior Fellow at the Center for American Progress, a co-founder of the Bipartisan Policy Center in Washington DC, and the author of Critical: What We Can Do About the Health-Care Crisis. He is married to Linda Hall Daschle and has three children and four grandchildren.

Customer Reviews

Most Helpful Customer Reviews

114 of 127 people found the following review helpful By Physician Reviewer on December 11, 2008
Format: Hardcover
Why is Tom Daschle (who interestingly is not a physician, but a lawyer, politician, and lobbyist) in charge of the health care arena in the first place? It's insulting to us physicians that the president elect couldn't find one of the many talented physician leaders to head up this project.

With that said, Daschle's main ideas gleamed from reading the book are:

1) Set up a Federal Health Board to regulate policy and provide evidence-based practices - The idea of a Federal Health Reserve is a good one. It would allow a nonjudgmental board to improve medical care at the federal policy level without political biases.

2) Expand Medicaid - This, although reasonable, is scary. Medicaid is amongst the lowest of all reimbursers. Many treatments and procedures simply cannot be done at the Medicaid reimbursement level, such that major academic centers with Federal support eat the costs of doing business with these patients. Any expansion will have to see reimbursement rates dramatically increased or physicians protesting.

3) Mandate by law (like in Massachusetts) that individuals have insurance - This seems like a good way to increase "insured individuals." What it does for quality of care remains to be proven.

4) Pay physicians based on their success - This is a slippery slope as it will reward physicians who are less apt to take risk. Also, deciding upon which outcome measures and variables to reward will be no easy task - the scientific community has only defined the variables for a very small subset of patient care items to date.

5) Open up the federal health insurance "group policy' to all employers and individuals to obtain an economy of scale - I don't know anyone with this insurance, but it seems like a fine idea.
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144 of 173 people found the following review helpful By Amazon Customer on February 19, 2008
Format: Hardcover
A big part of me resisted the idea of buying a book on health care written by a former Senator. It just seemed way too wonkish for me. But I am into politics and a minute does not go by without a candidate screaming about "Health Care" and "Universal Health Care" so I figured I should get up to speed on what the debate is all about.

I'm really glad I did. In truth, Critical is a well written book and is quite interesting. Daschle cogently explains why our current health care system is broken and why there is, in fact, a desperate need to fix it. I'd heard that said many times before but did not understand why. Now I do, thanks to this book.

I am a strong believer in the free market as the best means for providing most of the goods that people want at the best price. But I now have to admit that the free market is not working when it comes to health care. It really isn't. And I am not saying this as a Democrat. I am a registered Republican.

For those who might think that this book is nothing but a left-wing, socialist rant, they would be wrong. In fact, many of Daschle's recommendations for "fixing" the system are to make our system work the way it would in a true free market environment. That is, to provide the highest quality care at the least cost to the consumer. It was really eye-opening to learn how very far away from this ideal our current system is.

Daschle's book covers most of the bases. It describes our current system and why it is so flawed (the number one cause for bankruptcy in our country cannot be called a good system of health care!) He then describes the history of trying to create a better health care system in our country, starting with Truman, up to Clinton, and on up to the current day.
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45 of 53 people found the following review helpful By John Thornton on May 22, 2008
Format: Hardcover
I avoided learning about the politics of the mid-East for a long, long time. Too complex and insoluble. Then 9/11 and, well... I picked up "The Mid-East for Dummies" at Barnes and Noble. "It's a start," I told myself, and not a bad one as it turns out.

As a supposedly responsible political actor, I've found myself similarly ignorant when it comes to the droning debate on health care. And, God knows, listening to the candidates for President is not terribly edifying in this regard. "Tastes great, less filling" would pass nicely for substance on this (or almost any other) topic in this election season.

To my rescue rides Tom Daschle and his co-authors whose "Critical: What Can We Do About the Health Care Crisis" could have just as well been sub-titled "U.S. Health Care Policy for Dummies."

Unlike the "Dummies" books, this one is prescriptive. Senator Daschle et al bascically argue that the U.S. Congress is in over its head on health care and--like it did on monetary policy with the creation of the Federal Reserve in 1913--should outsource its decision making on the immensely complex topic to a Presidentially appointed panel of experts. This is a an interesting proposition, coming as it does from the former Senate Majority leader who hails from a state with deep populist roots. But the case he makes is not uncompelling.

Daschle calmly traces how health care reform has crashed repeatedly upon the same special interest shoals, at least since the Depression. The shape of the barely submerged obstacle may change (doctors, unions, insurance companies), but its sheer, hulking mass only increaseth. Congress, he argues, has neither knowledge nor institutional will to make good and far-sighted decisions on behalf of its constituents.
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