Last spring, after congress passed sweeping legislation to reform our nation’s health care system, the editorial board of the New York Times wrote: “Just as Social Security grew from a modest start in 1935 to become a bedrock of the nation’s retirement system, this is a start on health care reform, not the end . . . The process has finally begun.” One of the key voices in that process will be Philip Bredesen, who served as governor of Tennessee from 2003-2011. In Fresh Medicine—the first book to address this reform—Bredesen delivers a concise, intelligent analysis of what the reform is, how it is flawed and why we have to fix it.
Fresh Medicine
and over one million other books are available for Amazon Kindle.
Learn more
| ||||||||||||||||||||||||||||||
Book Description
Frequently Bought Together
Editorial Reviews
From Publishers Weekly
Beginning with the words "Health care in America is broken," and the claim that its underlying structure (insurance; uncoordinated providers) is obsolete, Tennessee governor Bredeson lays out a "new set of principles" to guide reform. While he supported President Obama's health care reform package, he now calls it "a stunning disappointment" and flags an inadequate funding mechanism and the act's failure to establish fiscal and quality control, which will lead to sky-rocketing costs. He proposes many improvement measures, including six well-considered "stepping stones," like the establishment of a trust account modeled on Social Security and financed by new taxes, and an independent audit of healthcare organizations, and would replace the recently-challenged mandate with a national voucher system. Prior to public service Bredesen founded and ran a managed-care company and, as governor, has been faced with overseeing TennCare, the State's controversial experimental program which, he writes, is an example of how a well-intentioned medical reform can spin "wildly out of control." Bredesen's belief in the value of direct experience led him to undertake this endeavor and he crystallizes that experience into a concise yet comprehensive effort.
(c) Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved.
Review
“In this important new look at a topic of urgent concern to the country, Phil Bredesen does something unique: he brings together the perspectives of a businessman, a politician, and an historian to tell the story of health care in America. Told with skill and grace, Fresh Medicine explains how we got where we are, and what we have to do going forward. Bredesen has given all of us a great gift.” —Jon Meacham, author of American Lion: Andrew Jackson in the White House
“Phil Bredesen knows the American health care system inside and out. He knows both the theory and, more importantly, how things really work. His perspective is unique and wise; if you’re interested in health reform, you’d do well to read and consider what he has to say.” —Bill Frist, M.D., former Senate majority leader
“Fresh Medicine is at once an indictment of the current state of our health care system and a pointed plan for a new model.”—The Nashville City Paper
“Few public officials in America are as experienced in health care issues as Tennessee’s governor, Phil Bredesen. He knows the subject from the standpoint of a health care management executive in the private sector and as the governor who rescued his state’s Medicaid program (and his state) from impending bankruptcy. He has distinctive views on how America’s broken health care system should be reformed. And he can express his ideas well.” —Mort Kondracke, Executive Editor and Columnist, Roll Call
“When it comes to health care, there is no one the nation's governors have relied on more than Phil Bredesen. He knows what he is talking about, and we respect his insights and the way in which he practices what he preaches.” —Gov. Joe Manchin (D-WV)
“Governor Bredesen’s unique combination of successful experiences in both the public and private sectors gives him an important voice in our national health care debate. His stewardship of TennCare and the innovation he has brought to expanding access to underserved Tennesseans show that he is a leader whose proposals deserve careful consideration.” —Scott Serota, President and Chief Executive Officer of The Blue Cross and Blue Shield Association
“Thought provoking.” —Memphis Medical News
“Phil Bredesen knows the American health care system inside and out. He knows both the theory and, more importantly, how things really work. His perspective is unique and wise; if you’re interested in health reform, you’d do well to read and consider what he has to say.” —Bill Frist, M.D., former Senate majority leader
“Fresh Medicine is at once an indictment of the current state of our health care system and a pointed plan for a new model.”—The Nashville City Paper
“Few public officials in America are as experienced in health care issues as Tennessee’s governor, Phil Bredesen. He knows the subject from the standpoint of a health care management executive in the private sector and as the governor who rescued his state’s Medicaid program (and his state) from impending bankruptcy. He has distinctive views on how America’s broken health care system should be reformed. And he can express his ideas well.” —Mort Kondracke, Executive Editor and Columnist, Roll Call
“When it comes to health care, there is no one the nation's governors have relied on more than Phil Bredesen. He knows what he is talking about, and we respect his insights and the way in which he practices what he preaches.” —Gov. Joe Manchin (D-WV)
“Governor Bredesen’s unique combination of successful experiences in both the public and private sectors gives him an important voice in our national health care debate. His stewardship of TennCare and the innovation he has brought to expanding access to underserved Tennesseans show that he is a leader whose proposals deserve careful consideration.” —Scott Serota, President and Chief Executive Officer of The Blue Cross and Blue Shield Association
“Thought provoking.” —Memphis Medical News
Product Details
Would you like to update product info or give feedback on images?
|
More About the Author
Discover books, learn about writers, read author blogs, and more.
Customer Reviews
|
Share your thoughts with other customers:
|
||||||||||||||||||||||
|
Most Helpful Customer Reviews
13 of 13 people found the following review helpful:
5.0 out of 5 stars
Fresh Medicine,
Amazon Verified Purchase(What's this?)
This review is from: Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System (Hardcover)
Tennessee Governor Phil Bredesen carefully explains why our present system of health care, including "Obamacare", cannot be sustained, and he offers his well thought out ideas regarding a complete overhaul. Since his career has been heavily involved with the current health care system, he brings first-hand expert knowledge to the issue. As a layman, I cannot vouch for the accuracy of his assumptions, predictions, etc., but his ideas appear to be sound.
The main thrust of his ideas is an almost completely new health care delivery system for every American, funded largely by employee/employer payroll taxes fed into a trust fund (similar to Social Security) and then distributed by the user via a voucher to a private "system of care", such as a major hospital with satellite clinics. These systems of care would be paid the fixed voucher amount (vouchers would vary in amount based on age, gender, location) and then be totally responsible for that user's care for the year. Users are free to choose their system of care from among competing private entities. Quality of care would be insured by the establishment of an independent (non-government) standards of care organization, which would establish standards, publish a "Red Book" of the standards, and then grade competing systems of care based on adherence to approved standard practices, while leaving plenty of latitude for individual physicians to deviate if justified. The system, as presented, has the advantages of simplicity, much less government involvement, full access by everyone without discrimination, and, most important, cost containment introduced solely by increased competition. This book is well worth reading as it presents the basis for a way forward out of the current health care mess we are in.
10 of 11 people found the following review helpful:
5.0 out of 5 stars
Informative, intelligent and thought provoking,
By
This review is from: Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System (Hardcover)
Governor Bredesen explains why the recently enacted healthcare reform won't work and offers an alternative framework for reformation of our troubled healthcare system that makes sense. Bredesen's experience as an entrepreneur, healthcare industry executive and a governor who inherited and managed a troubled state Medicaid system brings credibility to his analysis without becoming excessively wonkish. This book is not a discussion of healthcare reform as a political issue -- it is a discussion of it as a humanitarian and economic imperative.
6 of 6 people found the following review helpful:
5.0 out of 5 stars
Excellent -,
By
This review is from: Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System (Hardcover)
Health care in America is broken - it's costs are unsustainable and exceed those in any other nation, and it's outcomes often worse than those of much less affluent nations. The primary problem is that the our care system, with uncoordinated, unmeasured, and unstandardized care is obsolete. The 'bad news' is that ObamaCare has made things worse.
Fortunately, Tennessee Governor Phil Bredesen's "Fresh Medicine" provides a long-overdue, reasoned alternative. Previously he founded HealthAmerica Corp, an insurance company that grew to 6,000 employees, and had been a top contender to lead Obama's Health and Human Services Department. Unfortunately that didn't occur, thanks to those resentful of his previously tossing 200,000 off the state's Medicare rolls to control costs. 'ObamaCare' is not what the doctor ordered, according to Governor Bredesen. The underlying problem is its complexity. The Social Security Act took 15,600 words, while health care reform required 418,000. Governor Bredesen believes that provisions of the new health care program will encourage many employers to drop coverage because both they and their employees will be better off with the largely government-financed alternative. Extremely large and unbudgeted added costs will result for the federal government. Another problem that he foresees is that the new law will push further consolidation of hospitals and provider groups, increasing their monopoly power while weakening purchasers' clout. A third problem area is the establishment of voluntary long-term care insurance - actuaries already predict the fund will be bankrupt by 2025 due to adverse selection. A fourth is that game-playing with costs and savings has created considerable distortion and underestimating of reform costs, in addition to the preceding issues. Fifth is that the reform legislation's cost-reduction efforts amount to fluff, with minimal impact. Hopefully these problems will motivate revising ObamaCare along Bredesen's recommendations. Health care was already a serious problem, however, prior to ObamaCare. Bredesen compares U.S. costs vs. European OECD members - France is second highest, with costs as a percentage of GDP only two-thirds that of the U.S., while still providing 100% coverage. Our Asian competitors save an even greater margin - spending as little as one-third of GDP compared to the U.S. Among 30 OECD members, our infant mortality was exceeded only by Turkey and Mexico. (Don't blame our poor showing on minorities, either - Bredesen reports that removing non-whites boosts us only three more places, to also exceeding Hungary, Poland, and the Slovak Republic.) Comparing U.S. outcomes with other OECD nations on cancer, strokes, and heart attacks shows our results as roughly 'in the middle.' Bredesen's alternative health care model is best described as "HMOs on steroids." He recommends first establishing standards of care to guide providers for the most common, chronic ailments; these would be guidelines, however, not rigid dictates. Secondly, he'd implement quality audits (estimated cost - about 0.25% of the cost of care) to review adherence to those standards, and publicly report compliance percentages. (Considerable auditing already takes place with health care - however, much of it is meaningless and a waste of time.) His third recommendation is to give everyone vouchers for basic, comprehensive care, with the funding adjusted for age, sex, and area cost-of-living differences, and valid at any 'system of care.' (A 'system-of-care' would be responsible for providing or arranging all of an individuals needed care, per quality standards, within the allotted funding. Bredesen uses Mayo Clinic, with its associated hospital and outlying facilities as an example; other examples include Kaiser Permenente in California, and the Veteran's Administration.) More expensive care options would be covered only if research showed improved outcomes. Allowing choice would hopefully eliminate previous upsetness with HMOs because of their limited provider options. Bredesen's final recommendation would be to slowly squeeze reimbursements so that, over a 15-year-period, our costs would drop to 14% GDP. Bottom-Line: Governor Bredesen's recommendations are a welcome respite from the ignorant ideology and ballooning bureaucracy that have dominated recent health reform discussions and legislation. While it is tempting to quibble (eg. speed up 'real' reductions in reimbursement, cut further - to 10% of GDP, requiring long-term membership in a system-of-care to encourage better preventive care, and 'encouraging' shifting physician payment from predominantly fee-for-service to straight salary), the U.S. would greatly benefit from adopting his recommendations, verbatim. Bredesen, a Democrat, suggests that a good way to get started would be for President Obama to offer Republicans a 'mea culpa' for excessive initial partisanship while ObamaCare was developed and passed as a way to get everyone back to the table in a constructive spirit.
Share your thoughts with other customers: Create your own review
|
|
Inside This Book
(learn more)
What Other Items Do Customers Buy After Viewing This Item?
Tags Customers Associate with This Product(What's this?)Click on a tag to find related items, discussions, and people.
|
Customer Discussions
|
This product's forum
Active discussions in related forums
Search Customer Discussions
|
Related forums
|
Listmania!
|
|
