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Health Care Reform Now!: A Prescription for Change Hardcover – August 17, 2007

ISBN-13: 978-0787997526 ISBN-10: 0787997528 Edition: 1st
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Editorial Reviews


"He sets out one possible direction for health care reform." (BookNews, Feb 2008)

"…rich in insights and suggestions that make them compelling reading for anyone seriously concerned about U.S. Health Reform." (Health Affairs, Jan/Feb, 2008)

"This is a very readable book on the current status of reform possibilities facing the US health care system." (JAMA, Feb 2008)

"A management guru, Halvorson shows how the same principles Wal-Mart and Target use to lower consumer costs can be applied to health care." (www.outrageoustimes.com, 09/12/2007)


"George Halvorson convincingly argues that the United States finally has what it needs to make universal coverage a reality and lays out a plan to get us there. It should be required reading on Capitol Hill."
Congressman Pete Stark (D-CA),chairman, Ways and Means Health Subcommittee

"George Halvorson's timing couldn’t be better. This is a book that everyone who is searching for solutions should read."
Helen Darling, president, National Business Group on Health

"Halvorson's comprehensive approach, rooted in a practical understanding of the complexities of American health care, helps us focus on what matters."
Ian Morrison, Ph.D., healthcare futurist and author, Healthcare in the New Millennium

"This book is powerful and compelling.  It's just the right book for this time."
Jeffrey C. McGuiness, president, HR Policy Association


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Product Details

  • Hardcover: 361 pages
  • Publisher: Jossey-Bass; 1 edition (August 17, 2007)
  • Language: English
  • ISBN-10: 0787997528
  • ISBN-13: 978-0787997526
  • Product Dimensions: 6.3 x 1.2 x 9.2 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 3.5 out of 5 stars  See all reviews (15 customer reviews)
  • Amazon Best Sellers Rank: #609,849 in Books (See Top 100 in Books)

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Customer Reviews

3.5 out of 5 stars

Most Helpful Customer Reviews

5 of 5 people found the following review helpful By John D. Damore on July 5, 2008
Format: Hardcover Verified Purchase
George Halverson does an exceptional job at laying out the major issues facing the United States health care sector and systematically making practical suggestions for reform. Having been on the inside of Kaiser in California, Halverson has an in-depth knowledge of the complex interplay between physicians, payers, patients, providers, hospitals and the government. Four of his most powerful messages are how to harvest existing personal health records, the need to focus on chronic disease, how to create intermediary agents that pursue high quality and efficient care, and the fundamental necessity of universal health care coverage. Although that last reform is left-leaning, the author's perspective is balanced and he supports reforms to make health care markets work and reduce unnecessary administrative waste. One of his most resounding messages is that we get what we pay for in health care; currently we have over 9,000 billing codes for treating disease and not a single way to bill for a cure or maintaining wellness.

As a health care professional for the past six years, I highly endorse this book to both novices and experts alike. The challenges that await health care reform are large and complex, but it is the articulate and well-though advice of veterans like George Halverson that will make long-term advancement possible.
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8 of 10 people found the following review helpful By Elderbear VINE VOICE on March 7, 2008
Format: Hardcover
Halvorson has initiated a public conversation about health care in the United States. Halvorson postulates that adequate healthcare can be provided to everybody without increasing the cost of care. He would take advantage of the following:

* A small minority of the health care consumers use the major portion of health care dollars. The bulk of this is attributed to chronic illness that goes untreated until it becomes an acute (and expensive) crisis.

* The multi-provider model of health care currently in the market is extremely inefficient, especially when coupled with paper medical records.

* Cost shifting as the uninsured present to hospitals or emergency departments where they cannot be turned away. This is the most expensive care possible. These costs are shifted to private insurers.

Halvorson designs the idea of an IV or Infrastructure Vendor. The IVs will create medical record systems allowing individual providers access to all the information they need for a patient's total care. Reminders for tests and treatments for chronic illness will come up.

Halvorson sees that one primary problem with the American health care system is a badly incented market. Financial incentives exist for treating illness, not for securing health. His solution is to capitate payments for chronic illness so that the providers have more incentive to keep their patients healthy.

Finally, Halvorson would require health coverage for everybody so that no cost-shifting occurs. Halvorson embraces the "six sigma" concept for health care providers adhering to best practices and evidence based medicine.

Halvorson's reliance on medical information systems to help solve health problems is wishful thinking.
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18 of 24 people found the following review helpful By Book Maven on August 20, 2007
Format: Hardcover
As a former Senate staffer working toward my PhD in health care policy, I looked forward to reading a book on health reform written by the CEO of one of the largest health plans in the U.S, but I was very disapointed by this book. First of all, I thought Halvorson made many similar arguments Michael Porter makes in his book, Redefining Health Care.... Porter makes a convincing argument that we need a true "market" for health care that rewards quality outcomes (and considers costs). but Halvorson's patronizing "aw schucks" writing style and boring, yet self agrandizing personal anecdotes about his own health and leading Kaiser really wear on the reader (compared to Porter's book which is a great read).

In addition, through reading this book, I started to question how much the CEO of a membership based HMO really knows (or cares) about the uninsured. If Halvorson (and Kaiser) for that matter really wanted people to have coverage, they would see their fair share of charity care cases (uninsured) instead of sending them to the safety net...something Kaiser is notorious for, at least in California.

Instead, in his chapter on a plan for universal coverage, Halvorson proposes using a sales tax and employer fees to give everyone coverage...which would mean, more paying members for Kaiser. Not exactly health care reform now when you get down to it.
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2 of 2 people found the following review helpful By Loyd E. Eskildson HALL OF FAME on April 6, 2010
Format: Hardcover
Halvorson's book is an excellent background source for anyone looking for an overview of health care economics. The book clearly benefits from his years of experience as a health care administrator - now CEO of Kaiser Permanente. Halvorson begins by pointing out that acute (non-chronic) health conditions often get the most public attention because each case can be very dramatic and made visible by the media. However, the most frequent uses of acute care (cancer, maternity, trauma, infectious diseases) are relatively minor cost contributors - eg. cancer and maternity care respectively contribute only 4% and 5% to total health spending. Five types of chronic care (diabetes, congestive heart failure, coronary artery disease, asthma, and depression) generate the overwhelming costs (75%). Each tends to be progressive, and those getting the most expensive care usually have two or more of the five, or at least an added acute problem. (Additional chronic problems are usually referred to as 'comorbidities.') Hypertension is also an important health care problem because it is the underlying condition that leads to heart failure and exacerbates the complications of diabetes.

Diabetes is the chronic condition that receives the most attention from Halvorson, and he makes a good case for doing so. About 32% of Medicare costs go to treating diabetes, kidney failure in the U.S. is most often a complication of late-stage diabetes, and it also is the #1 cause of new blindness, foot/leg amputations, and is strongly linked to heart failure as well. Despite these potentially serious outcomes, diabetics only receive proper treatment 8% of the time per expert-determined care protocols, the rate of U.S. obesity has nearly tripled since 1980, and it is now 2.5X that of the OECD average.
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Health Care Reform Now!: A Prescription for Change
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