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Health Against Wealth: HMOs and the Breakdown of Medical Trust Hardcover – November 13, 1996

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Editorial Reviews Review

If you have ever sought pre-approval for a necessary medical treatment, or have had problems arranging appointments with a specialist, or have seen a personal-care physician transferred to a distant clinic, George Anders's book on the growth of health maintenance organizations (HMOs) will confirm your worst fears. A reporter for the Wall Street Journal, Anders provides a series of horrifying case studies: a six-month-old baby who loses his hands and feet after a 42-mile journey to an HMO-approved emergency room; residents of a small town in Tennessee afflicted with an outbreak of a painful bowel infection who find that the drugs needed to suppress the epidemic are not covered; HMOs that select hospitals with low success rates for heart-bypass operations because of cost factors. Anders presents a powerful indictment of the emerging managed-care model for our national health-care system in this disturbing book.

From Publishers Weekly

Do HMOs deliver what they market? Wall Street Journal reporter Anders alerts the HMO subscriber to be on guard. Exposing faults with the intent of suggesting reforms, his book could become the energizing catalyst to bring them about, especially since corporations contracting HMOs for their employees have only recently begun to monitor the quality of care proffered by this largely self-regulated industry. For-profit HMOs spend on average 70%-75% of premiums on patient care, while nonprofit HMOs spend 90%. Anders publicizes the salaries of several for-profit CEOs: the chief executive of Foundation Health in 1994 had a $19 million pay package; Humana chair David Jones is one of the richest men in Kentucky. Not just statistics but also well-documented anecdotal evidence makes Anders's arguments alarming as he portrays life-threatening cost-cutting practices. Healthy patients have little cause for dissatisfaction with HMOs, stresses the author, but the elderly and those with medical emergencies or severe illnesses are generally treated on the cheap. Treating patients as production units flowing through a medical factory may be cost-effective, but Anders?he's insured by an HMO, his wife prefers traditional indemnity coverage?shows that quality controls have not been factored in. His book will have readers restudying their HMO plans, this time as informed subscribers. 40,000 first printing; first serial to the Wall Street Journal; author tour.
Copyright 1996 Reed Business Information, Inc.

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Product Details

  • Hardcover: 299 pages
  • Publisher: Houghton Mifflin; 1 edition (November 13, 1996)
  • Language: English
  • ISBN-10: 0395822831
  • ISBN-13: 978-0395822838
  • Product Dimensions: 8.9 x 6.2 x 1 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 5.0 out of 5 stars  See all reviews (1 customer review)
  • Amazon Best Sellers Rank: #450,613 in Books (See Top 100 in Books)

More About the Author

I've been writing about dreamers, idealists and rascals since 1981. Look for my articles and essays these days at Forbes magazine,, and the LinkedIn/Influencers program. Other writing homes over the years have included The Wall Street Journal, Bloomberg View and Fast Company magazine. I've also launched a travel blog, written five books and spun out several hundred bedtime stories for our kids.

In 1997, I shared in the Pulitzer Prize for National Reporting.

I grew up on the South Side of Chicago. As an adult, I spent time in New York City, London, Cambridge MA and Washington DC before settling in northern California. I'm a slow but stubborn hiker. Adventures over the years have included trekking in Nepal, Peru and New Zealand, as well as making it to the top of Mt. Whitney, Mt. Fuji and Cerro Chirripo. Some of my favorite writers include Thomas Boswell for sports; William Manchester for biographies; Caroline Baum for financial commentary and Michael Craig for poker.

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Most Helpful Customer Reviews

12 of 12 people found the following review helpful By Ernest Fruge on January 11, 1998
Format: Hardcover
As a journalist, not a health service provider, Mr. Anders brings credibility to his examination of our current health care system. His matter-of-fact style and even-handed presentation of the abuses of the traditional, fee for service model, the positive strengths of managed care, and the responsibility of the consumer in building a workable system further enhance his credibility. In this broad review of health care, Mr. Anders points out that the initial goal of managed care was to secure high quality, affordable, efficient health care by making sure patients received the right treatment by the right provider at the right time. He credits HMO's with redirecting medical priorities to preventive care away from costly, late-stage care. Mr. Anders discusses how the well-intended but inappropriate application of traditional business practices accidently created powerful loopholes and incentives for abuse, in part, because consumers and purchasers were naive about the great potential for unethical profiteering by managed care. The organization of the book makes the complicated issues in health care more understandable. Complex issues are discussed in separate chapters organized by topic areas such as emergency care, medicare and mental health care. Mr. Anders combines factual technical information with evocative personal testimonies from patients, providers, managed care executives and others. Mr. Anders' bottom line is that truly sick, vulnerable or atypical patients are poorly served by for-profit managed care. While Mr. Anders mainly focuses on the dark side of managed care, a great strength of the book is that he does not leave the reader feeling hopelesss or overwhelmed. In his final two chapters, he addresses quality and gives specific suggestions for building a balanced, better system. This easy read is an indispensible resource for those interested in promoting a health care system characterized by compassion, competence, and cost-effectiveness.
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