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Health Care Half Truths: Too Many Myths, Not Enough Reality (American Political Challenges) [Kindle Edition]

Arthur Garson
4.3 out of 5 stars  See all reviews (6 customer reviews)

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Book Description

Health Care Half Truthsi diagnoses the health care crisis, addresses and debunks 20 commonly held perceptions, and delivers a system that meets the needs of patients, physicians, and politicians.

Editorial Reviews

From Publishers Weekly

Starred Review. A much-needed dose of realism, this state-of-the-policy report should be required reading for anyone weighing in on the debate over health-care reform, especially students of health policy. Dean Garson and policy analyst Engelhard, both of the University of Virginia's School of Medicine, show how both defenders and opponents of the current American health-care system rely on false truisms and lazy thinking, such as the idea that most health-care dollars are spent in the last six months of life, or that consumer choice automatically improves care. Members of Congress cling to the hope that quality improvement programs or more preventive care will save enough money to bail out Medicare and other programs, but Garson and Engelhard expose the flaws in these arguments. Thanks largely to its well-thought-out structure, this book makes a surprisingly quick read; in the introduction, for example, the authors' myth vs. reality chapter descriptions make for easy browsing and reference. The sheer number of misconceptions exposed and the seemingly intractable dysfunction of the health-care system as a whole result in a sobering tour, but the final chapter proposes some sound, if occasionally controversial, solutions. Though more general readers may balk at some tedious hair-splitting, this title successfully flushes the plaque from the hardened arteries of the country's health-care dialogue.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

Review

A much-needed dose of realism, this state-of-the-policy report should be required reading for anyone weighing in on the debate over health-care reform, especially students of health policy. Dean Garson and policy analyst Engelhard show how both defenders and opponents of the current American health-care system rely on false truisms and lazy thinking, such as the idea that most health-care dollars are spent in the last six months of life, or that consumer choice automatically improves care. Members of Congress cling to the hope that quality improvement programs or more preventive care will save enough money to bail out Medicare and other programs, but Garson and Engelhard expose the flaws in these arguments. Thanks largely to its well-thought-out structure, this book makes a surprisingly quick read; in the introduction, for example, the authors' myth vs. reality chapter descriptions make for easy browsing and reference. The sheer number of misconceptions exposed and the seemingly intractable dysfunction of the health-care system as a whole result in a sobering tour, but the final chapter proposes some sound, if occasionally controversial, solutions. Though more general readers may balk at some tedious hair-splitting, this title successfully flushes the plaque from the hardened arteries of the country's health-care dialogue. (Publishers Weekly)

I could not put this book down! Every American should read it! (Wayne Turnage, Deputy Chief of Staff for Virginia Governor Tim Kaine)

A realistic perspective on our health care system that is highly informative yet refreshingly optimistic when it comes to needed change. (Steven A. Wartman, MD, PhD, President and Chief Executive Officer, Association of Academic Health Centers)

How exhilarating it is to read a book on health care policy that dispels delusions—that prevention always saves money, that we can stop growth of health care spending without rationing, that doctors always know what they are doing, that the uninsured and poor always get at least emergency care, and the biggest delusion of all—that there is no politically achievable way to extend health insurance coverage to all Americans. (Henry J. Aaron, The Brookings Institution)

Before one can make a cure, one has to get the right diagnosis. This book is an outstanding addition to the debate on fixing American healthcare with its thoughtful exposure of myths with well researched reality. It is a must read for the public, payers, physicians and policy makers. (J. James Rohack MD, Director, Scott and White Center for Healthcare Policy)

Health Care Half-Truths is a great resource for the public and for policy makers as they tackle what has become a mired behemoth—healthcare in America. Whether trying to get in to a doctor, affording the charges, or understanding the systems, healthcare often overwhelms us as consumers as well as those who seek to put forward sound policy. If you want to understand how we got where we are or if you want to start making changes, Health Care Half-Truths is a valuable place to start. (Jane Woods, former Secretary of Health and Human Resources, Commonwealth of Virginia)

Health care now accounts for one-sixth of the entire US economy, yet it is misunderstood by almost everyone. By challenging common myths about health care, Garson and Engelhard artfully help readers of all levels of expertise gain a far better appreciation of the strengths as well as the problems of our health care system. (Stuart M. Butler, Vice President for Domestic Policy, The Heritage Foundation)

Garson and Engelhard make a fundamental point that all policymakers, business leaders, and healthcare stakeholders must hear: change is possible. Despite all the myths, half truths, and real-world problems, we can build a 21st century intelligent health system that saves lives and saves money for every American. The authors pull no punches, and by doing so make an important and lasting contribution. (Newt Gingrich)

Health Care Half-Truths is a fascinating book dealing with one of the most important and seemingly intractable issues of our time in the United States: equitable and high quality health care. . . . The book is highly recommended to students and teachers as well as policy makers, health care workers and anyone interested in a deeper understanding of today's health care dilemma. (David J. Skorton, M.D., President, Cornell University)

Health Care Half-Truths contributes significantly to the debate over health reform by correcting the biggest myths about health care in the United States. Dr. Garson and Ms. Engehard answer the false perception that the U.S. offers some of the worst health care in the developed world and even that preventive care always saves money, for example. By starting with a clearer diagnosis of the problems in the health sector, they believe policymakers will be able to build on its strengths and correct its weaknesses. The book gives policymakers a big dose of reality to guide their decisions. (Grace-Marie Turner, President, Galen Institute)

Health Care Half-Truths is a provocative and important book—easy to digest and stimulating to the mind! By challenging the conventional wisdom, it forces all of us to rethink what we know about American health care. (Karen Davis, President, Commonwealth Fund)

Garson and Engelhard...offer an excellent, well-documented text...the book offers extensive up-to-date references and resources separate from the straightforward text. Summing Up: Recommended. All Levels. (J.E. Thompson, Western Michigan University CHOICE)

Product Details

  • File Size: 2210 KB
  • Print Length: 272 pages
  • Publisher: Rowman & Littlefield Publishers, Inc.; 1 edition (April 15, 2007)
  • Sold by: Amazon Digital Services, Inc.
  • Language: English
  • ASIN: B002Z14LBG
  • Text-to-Speech: Enabled
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  • Word Wise: Enabled
  • Lending: Not Enabled
  • Amazon Best Sellers Rank: #1,358,669 Paid in Kindle Store (See Top 100 Paid in Kindle Store)
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Customer Reviews

Most Helpful Customer Reviews
7 of 7 people found the following review helpful
3.0 out of 5 stars Health Care Half Truths Misses Some Big Issues June 28, 2008
Format:Hardcover
This book does provide some good background into a lot of the various issues involved in our broken, health care system in the USA. For someone new to this field, Garson and Engelhard give some valuable insight into many of the complexities that have developed over the past 20 - 30 years. It does point out that there is a difference between medical care and health care. Obviously the medical care definition reflects a restricted scope and the rather obvious bias of a medical doctor. The authors contend that our USA medical care (the physician and patient relationship only)is about the best in the world; witness all the people who come to this country for surgery and complex medical care. However, the book is weak in identifying the shortcomings and errors in hospital service and doctor malpractice. A new emphasis on transparency in service and costs is not developed nearly as strongly as it should be.

Another subject that has not been investigated at all is the make-up of the uninsured 45 million residents in our country. Chapter 15, "Myth:People Who Work Can Afford Insurance" includes this one key sentence, "However, there are 11 million people -twenty five percent of the uninsured-who probably CAN afford health inssurance coverage, with family incomes over $50,000 (after all, the same family plan in the individual market used for our low income family would amount to less than ten percent of income)." That is all that is said in the entire book about this gross inequity between who pays and who doesn't. When Governor of MA, Mitt Romney's bi-partisan commission examined the uninsured in his state, it found that over 50% of those claiming uninsured status could afford a health insurance plan.
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7 of 7 people found the following review helpful
Format:Hardcover|Verified Purchase
Dr. Arthur Garson and Carolyn Engelhard both of the University of Virginia Medical School (at least according to the book jacket) have written a clear, intelligent, factually-based analysis of the healthcare system in the USA. The book is similar to A Second Opinion by another physician/academician/administrator, Dr. Arnold Relman, whose background seems to be similar to that of Dr. Garson. Both have experience and knowledge that permit them to accurately analyze and comment on the full range of issues from the science and practice of medicine to healthcare policy.

The tack that Dr. Garson and Ms. Engelhard have taken is to identify half truths in various segments of the healthcare system, then discuss what is the true half and what is the false half of each half truth.

The introduction to the book lists 20 myths (aka half truths) that are later treated in detail in each chapter. The first myth listed is "American medical care is second-rate compared with other countries", myth three is "American wastes one-half of its medical care dollars", "America will not ration medical care".

The authors briefly discuss each myth after stating it in the introduction. For that reason a busy policy-maker or other interested party could simply read the introduction to gain an excellent understanding of the current system and to understand which issues are the most salient and why. The introduction debunks virtually all of the unsubstantiated assertions that physicians, politicians and average patients/taxpayers assume to be true simply because they are constantly repeated.

As an example, in the first chapter after the introduction, the authors make the important distinction between the medical care/medical care costs and healthcare/healthcare costs.
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7 of 7 people found the following review helpful
5.0 out of 5 stars Very clear, quick intro to US health care system in 2007 November 27, 2007
Format:Hardcover
This book is an excellent, up-to-date overview of how the health care system works as of today. It assumes little prior knowledge, although you might have deeper understanding if you have some (they talk about the Clinton health care reform plan of 1994 but spend little time explaining what it would have done). The book is phrased as a series of "myths," but that seems to me just a gimmick that they fit around whatever they want to talk about. Who knew that a common myth was "People Who Work Can Afford Health Insurance?" It seems to me that the fact that they can't is rather well-known.

The authors' stated goal is to give factual information about the American health care system, and as such, the last half of the book is simply a references/further reading section. So the book is much shorter than it appears (but I think this is a strength, see below).

But there is some excellent stuff in here.

* They point out the leaps in some flawed arguments, like "The quality of care in the U.S. is bad because we have low life expectancy and high infant mortality."
* They do puncture some real myths, like "half of all medical spending occurs in the last year of life."
* They challenge some important story lines used by reformers, like "Preventive care saves money." (Sometimes it does, but many times it costs money. And the same for the opposite -- smoking usually saves money.) Another is "No Additional Money Is Needed To Cover The Uninsured" (a candidate favorite).

There are a few running themes throughout. Uninsured and underinsured people are bad for the system, and the system is bad for them. There are process and technology improvements that would be helpful in more efficiently providing medical care.
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