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Fixing American Healthcare - Wonkonians, Gekkonians, and the Grand Unification Theory of Healthcare [Kindle Edition]

Richard N Fogoros
4.6 out of 5 stars  See all reviews (7 customer reviews)

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  • Length: 352 pages
  • Prime members can borrow this book and read it on their devices with Kindle Owners Lending Library.
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Book Description

In "Fixing American Healthcare," Richard N. Fogoros ("DrRich" of the award-winning Covert Rationing Blog) explains the American healthcare system in a way you've never heard it explained before.

He describes the epic battle between the Wonkonians (the people who want to regulate our way out of the mess we're in) and the Gekkonians (the people who want to cure our healthcare problems by maximizing profits) - and demonstrates why they're both wrong.

He also introduces the Grand Unification Theory of Healthcare - a system for understanding the essential features, and the fundamental behaviors, of any healthcare system you can imagine. We can use the Grand Unification Theory of Healthcare to analyze any proposed healthcare solution, and compare it to any other proposed solution, simply and rationally. Even better, we can use it to devise a real fix for the American healthcare crisis - a uniquely American solution, one that provides universal coverage while still encouraging individual responsibility and controlling costs.

After you read this book, you will never look at the healthcare system in the same way again.

Editorial Reviews


The nuts and bolts of covert healthcare rationing are surgically exposed in a new book by Richard N. Fogoros. Fogoros is a former cardiologist who has authored textbooks, consults for companies developing new medical technologies, and hosts the heart disease information site at Now he's written a fine blueprint for radical health-care reform. Fixing American Healthcare is a survival guide every patient deserves. --Igor Greenwald,

Must reading for all people involved in health care. Reading Fixing American Healthcare is like reading an Ayn Rand novel, a murder mystery (how the doctor-patient relationship has been killed), a philosophical treatise, an investigative report, and an expose of Wonkonian and Gekkonian agendas. Richard Fogoros reasserts the primacy of the doctor-patient relationship by proposing a balanced solution to the healthcare crisis that addresses the needs of society, physicians, patients, business, and government. Quite an accomplishment. --Lynn Carlisle, DDS,

Unlike others who dance around the topic or try to have it both ways, Fogoros doesn t shy away from embracing bold, unpopular ideas as cornerstones of his solution. Fogoros makes a compelling case that the problem with our current health care system is covert rationing, which has profound corrosive effects. Once the problem is laid out, Fogoros proposes a solution that encompasses open rationing and is characterized by six key principles, one of which is that healthcare coverage must be universal. Presidential candidates who advocate the same thing should study Fogoros s book to see how it might actually be done. --David E. Williams,

About the Author

Richard N. Fogoros is a former professor of medicine who spent over 20 years as a full-time clinical cardiologist, medical researcher, teacher and author, as well as an occasional healthcare entrepreneur, amateur medical ethicist and, when absolutely unavoidable, patient. Since 2000, he has made his living consulting with biotech companies and writing.

He is the author of popular introductory textbooks simplifying an arcane specialty (cardiac electrophysiology) for medical novices. For seven years he has covered heart disease and cardiology for the network of websites. There, "DrRich" has written hundreds of articles for the general reader aimed at simplifying complex and controversial topics in cardiology. Similarly, he works to make the (intentionally) complex American healthcare system accessible to average citizens through his website (, his blog (, and now, through Fixing American Healthcare

Product Details

  • File Size: 567 KB
  • Print Length: 352 pages
  • Simultaneous Device Usage: Unlimited
  • Publisher: Publish or Perish DBS; First edition (October 1, 2007)
  • Sold by: Amazon Digital Services, Inc.
  • Language: English
  • ASIN: B003U2RVU2
  • Text-to-Speech: Enabled
  • X-Ray:
  • Word Wise: Not Enabled
  • Lending: Enabled
  • Amazon Best Sellers Rank: #1,299,082 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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Customer Reviews

4.6 out of 5 stars
4.6 out of 5 stars
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Most Helpful Customer Reviews
5 of 5 people found the following review helpful
When exposed to models, I learned to appreciate simple first and complex next. This book introduces the reader to health care challenges in the right sequence: Simple first.
As a systems architect for more than 35 years, this book has gained my utmost respect. What the health care system lacks is correct feedback. Patient entitlement, social carrying capacity, doctor decisional independence or lack of, accountability at various levels and so on are all lacking basic systemic sanity. As Lord Kelvin said in the late 18XX "you can not control what you can not measure". If professional competence is removed from decision of service, services are removed from payment ability, outcomes are removed from services and quality of life is defined by somebody else, nothing can be really stabilized, except in political fairy-tales. Another prediction from the world of systems theory; as per the second law of Thermodynamics and the Nyquist principle, all systems without control end in chaos. QED now we know.
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3 of 3 people found the following review helpful
Format:Paperback|Verified Purchase
Dr. Fogoros goes where few other authors on health care reform/transformation can go. He does an extraordinary job taking us inside the health care system and exposes many frightening truths:

*We ration care, we just don't call it that
*Doctors have been strong armed into putting the interests of employers, insurance companies and the government ahead of patient interests
*Money talks and when your insurer is a for-profit company they are obligated to make the highest profits possible and they put their profits ahead of your health
*Private insurers intimidate doctors to ration care and increase corporate profits
*Money talks and when your government is trying to save money they put their budget ahead of your health
*The government intimidates doctors to ration care and decrease spending
*Scientific studies are manipulated to support rationing of care
*Doctors have been complicit, through action and inaction, in destroying the patient-doctor relationship and consequently supported covert rationing of care

Almost no one is blameless when it comes to being responsible for the mess we are in.

Dr. Fogoros shows us how who pays for your care and who decides what care you can and can't have determines the quality of the system we have and the care we receive. He shows us how insurers and our government programs, Medicare and Medicaid, ration care without our knowledge and consent, sometimes hiding behind suspect science.

And he shows us how we will have to ration care because we just can't pay for everything for everybody. Americans have a "no limits" mentality when it comes to the care we want. Unfortunately we do have a limited budget and will need to learn to ration care openly and with compassion.
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1 of 1 people found the following review helpful
We all know we're facing many challenges in our health care system. Certainly at a national level, we need solutions to deal with the fact that there are 50 million uninsured people in America.

But individually, many of us access our health care through a less-than-perfect system of health insurance and HMOs. And we are up against a challenge that is coming to be known as "covert rationing" -- a term coined Fixing American Healthcare's author Dr. Richard Fogoros, MD -- known as "DrRich." With covert rationing, not only do insurance companies do such obvious things as try to cancel policies when we're sick, but behind the scenes, they are doing whatever they can to systematically deny patients access to specific information, experts, specialists, procedures, treatments, and medications we may need.

But how do we learn about these covert tactics? How do we find out exactly what is going on behind the scenes in doctor's offices, hospitals, as well as the offices of drug companies, insurance companies and HMOs around the country? How can we know what the doctors and insurers and HMOs don't tell us -- and don't want us to know?

The answer: Fixing American Healthcare: Wonkonians, Gekkonians, and the Grand Unification Theory of Healthcare. Full disclosure here: I wrote the foreward for DrRich's book. More disclosure: I happily volunteered to do it, because as a thyroid patient advocate, part of my role for the last decade has been to help expose the many ways our medical system is failing us, as relates to our thyroid disease. I was seeing covert rationing in action -- I just didn't know what it was called until DrRich came along!

There's a bigger picture.
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1 of 1 people found the following review helpful
5.0 out of 5 stars Thought provoking April 30, 2008
Format:Paperback|Verified Purchase
Dr. Fogoros foregoes the usual cliches seen in proposing health care fixes. His analysis of our current system, including how we got here, is very insightful, and rings true to someone working in healthcare. American healthcare is very complex and won't be fixed in a sweeping reform, especially by the government, so it is difficult to propose changes in a scientific way, but he backs up his proposals with sufficient anecdotes and facts to make them plausible. A must read for someone interested in the future of our healthcare.
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