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Health Care Will Not Reform Itself: A User's Guide to Refocusing and Reforming American Health Care [Hardcover]

George C. Halvorson
4.5 out of 5 stars  See all reviews (19 customer reviews)

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Book Description

May 27, 2009 143981614X 978-1439816141 1

Health care reform is within our reach. According to George Halvorson, CEO of the nation's largest private health care plan, only by improving the intent, quality, and reach of services will we achieve a health system that is economically feasible into the future.                                                                       

This year, Americans will spend 2.5 trillion for health services that are poorly coordinated, inconsistent, and most typically focused on the belated care of chronic conditions. What we have to show for that expenditure is a nation that continues to become more obese, less healthy, and more depressed.

In Health Care Will Not Reform Itself, Kaiser Permanente CEO George Halvorson proves beyond a doubt that the tragically inconsistent care that currently defines the state of U.S. health services is irresponsible, irrational, but more importantly, fixable. With detail that might shock you, he shows why the nonsystem we now use is failing. Then, applying the same sensible leadership that makes Kaiser the most progressive health care organization in the world, he answers President Obama’s mandate for reform with a profound incentive-based, system-supported, goal-focused, care-improvement plan.

Halvorson draws from respected studies, including his own, and the examples of successful systems across the world to show that while good health care is expensive, it is nowhere near as costly as bad health care. To immediately curb care costs and bring us in line with President Obama's projected parameters, he recommends that we:

  • Take a preventive approach to the chronic conditions that account for the lion’s share of medical costs
  • Coordinate patient care through a full commitment to information technology
  • Increase the pool of contributors by mandating universal insurance
  • Rearrange priorities by making health maintenance profitable
  • Convene a national committee to "figure out the right thing" and "make it easy to do"

While this book offers sage advice to policy makers, it is also written to educate the 260 million stakeholders and invite their participation in the debate that is now shaping. What makes this plan so easy to understand and so compelling is that it never strays from a profound truth: that the best health system is one that actually focuses on good health for everyone.

All royalties from the sale of this book go to Oakland Community Voices: Healthcare for the Underserved

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Editorial Reviews


When running for office, President Obama pledged to expand health insurance coverage while reducing the cost of care by $2500 per year for the average family. Skeptics scoffed that industry insiders would block this goal in defense of their interests. Now George Halvorson, CEO of the nation’s largest health care delivery system, says reducing costs while expanding coverage not only should be done, but can be done, and tells us how. His book highlights the important role and many forms of connectivity in health care: electronic medical records for patients and physicians, registries and care coordination programs for chronic illness, mandates and exchanges for health insurance, the alignment of culture and incentives among the many contributors to the wellbeing of patients.
Dr. James Robinson, PhD, MPH Professor of Health Economics, UC Berkeley

Clear, concise, and compelling, George Halvorson’s latest contribution clarifies why we must change, how we must change, what we must change, and when we must change. The answer is now. Drawing on the learnings from Kaiser Permanente’s transformation to a fully digitally enabled, integrated system of care, George Halvorson shows all of healthcare how to focus on the right goals and improve our performance in reaching those goals.
— Ian Morrison Futurist; Author of  The Second Curve: Managing the Velocity of Change and Healthcare in the New Millennium

George Halvorson offers a timely and compelling prescription to addressing the chronic ills of our health care system. One doesn’t have to agree with every proposal to appreciate the extraordinary contribution he has made here. Students of health reform would do well to consider this book as an invaluable text for our national public policy debate.
Tom Daschle, Former U.S. Senate Majority Leader

George Halvorson’s timing couldn’t be better and his message couldn’t be more valuable. He documents in clear, vivid prose why the health care system won’t reform itself which all employers and payers need to understand so they don’t miss this pivotal moment to dramatically reform health care. He offers information, evidence and practical solutions for aggressively attacking the "crushing burden of health care costs," as President Obama described our national challenge. Halvorson also provided ways we can sharply improve quality and safety, as well as save substantial dollars. He reminds us again, through many excellent examples, how essential it is to have electronic health records for effective, appropriate care at a reasonable cost. This book provides a great checklist for healthcare reform for the public and the private sector. I strongly recommend it.
Helen Darling President, National Business Group on Health

Halvorson’s simple, direct writing style is remarkable for its clarity. He takes complex problems and makes them understandable. Halvorson’s experience as leader of one of the world’s largest and most successful implementations of health information technology makes his insights into that subject particularly valuable.
Dr. Alain C. Enthoven, PhD Marriner S. Eccles Professor of Public and Private Management, Stanford University

About the Author

Kaiser Permanente, Oakland, California, USA

Product Details

  • Hardcover: 184 pages
  • Publisher: Productivity Press; 1 edition (May 27, 2009)
  • Language: English
  • ISBN-10: 143981614X
  • ISBN-13: 978-1439816141
  • Product Dimensions: 0.6 x 6.1 x 8.9 inches
  • Shipping Weight: 14.4 ounces (View shipping rates and policies)
  • Average Customer Review: 4.5 out of 5 stars  See all reviews (19 customer reviews)
  • Amazon Best Sellers Rank: #345,211 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews
15 of 18 people found the following review helpful
Format:Hardcover|Verified Purchase
With all the current interest in health care reform, I found this an excellent book to provide hope and background for those of us who favor health care reform under President Obama. Written by the current CEO of Kaiser Permanente, the book systematically provides areas where cost-savings can be achieved in an easy-to-read-and-follow format.

His first and, perhaps, most important suggestion, is, to me, a blockbuster. Per Halvorson, if we get everyone in our country insured, this, by itself, should reduce the average annual cost of health care insurance to a family of four by about $1,200. (The average cost to a family, he tells us, is now about $12,000 per year.) This cost reduction, if it could be sold to more folks in the current health care reform debate, could, of course, be a very strong argument in favor of the "public option." But Halvorson does not really tell us exactly where this savings would come from. He infers that it would be in the insurance company premium, itself. But the book is embarrassingly short on much of any criticism of insurance companies, their CEO salaries, their profits and administrative costs, etc. It is one of the flaws of the book, for sure. Perhaps the only flaw.

The strength of the book, again, is to give us hope that overall health care costs can, over time, be reduced and controlled. To get another $1,300 annual reduction, on top of the $1,200 above, he says "We need to reduce the costs of care by improving care.
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4 of 4 people found the following review helpful
5.0 out of 5 stars My congressman should read this book October 5, 2009
This book is probably the best explanation I've read on why we have the health care mess that we do in the United States. We read a lot about health care in the papers and hear stories on the news but few articles get into the real reason for the problems and even fewer into what would be a really good solution. I learned far more from this book than I have from all the other sources put together. It was interesting in the way it discussed the health system in this country compared to that of some of the other countries in a manner that was easy to understand with many examples.

I didn't realize until I finished the book that George Halverson is the CEO of Kaiser Permanente, the largest not-for-profit health plan and care system in America with over eight and a half million members. My sister worked for a company that was insured by Kaiser and she was very impressed by the electronic medical record system at Kaiser. She was able to see all of her medical test results as soon as they came back from the lab just by logging onto a password protected website and was able to see comments from any doctors or specialists she had seen in the system. She was also able to make doctor's appointments online and email her doctors. They in turn could see any medications prescribed by any of the other doctors and any comments on any condition. Halverson talks about such a system for everyone in the country and mandating that everyone be insured which would help to slow down the increases in the cost of healthcare.

According to Halverson, at least 50% of the visits to an emergency room for asthma attacks don't need to happen. Treatment for the condition varies so much from doctor to doctor and the outcomes can be very different.
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2 of 2 people found the following review helpful
5.0 out of 5 stars Practical Ideas for Reducing Health Care Costs September 16, 2009
George Halvorson is on to something here. You're never going to reduce health care costs until you improve health care quality. Providing better, proactive or preventive care reduces the severity of disease, complications, hospital stays, etc. When you provide quality care to a patient, his or her lifetime medical costs go down. When you provide poor quality care, the costs go up because the patient is sicker and needs more care. It is pretty simple when you think about it, but the current U.S. health care system does not provide incentives for doctors and hospitals to provide quality care, it only provides incentives (in the form of payments) for the volume of care they deliver.

If health care providers care about reducing costs now, there are actually steps they can take today, as Halvorson describes in chapter 3, "Set Goals and Improve Care." There are a handful of preventable medical events that are enormously expensive because of the hospital stays and expensive treatments that go with them. Picking three examples, Halvorson says we can reduce by 50 percent the number of kidney failures, asthma crises and heart attacks. With rare exceptions, no one in America should end up in an emergency room with an asthma crisis, because it is preventable through education and preventive care. At a local level, health care providers can start planning today and setting goals to reduce these incidents.

But as much as I like George's book and approach, I fear that the majority of our nation's health care providers are more concerned about their bottom line than patients like you and me.
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Most Recent Customer Reviews
5.0 out of 5 stars Excellent book
Although the book arrived late, however, seller was able to waive the selling cost. I enjoy every page of the book and would recommend it to anybody interested in American health... Read more
Published 9 months ago by Chris madu
4.0 out of 5 stars Great book to change an industry!
Halvorson does a great job highlighting why we need change US healthcare and how to do it.

Truly, it boils down to simple things like collecting pertinent information,... Read more
Published 16 months ago by Hugh Morris "E" ;)
4.0 out of 5 stars Good Overview
George is a well known and respected health care leader and has great insight into the industry from an insurance perspective. Read more
Published 19 months ago by Chuck Van Vorst
5.0 out of 5 stars worth reading, whether you are on the right or the left
I would not have expected a compelling, engaging, witty book on this subject. I was braced for "dry." But anyone remotely interested in health care reform should read this book. Read more
Published on May 19, 2012 by Book Nut
5.0 out of 5 stars Great Guide to the Healthcare Debate
Wonder why the the Affordable Care Act is 2600 pages in length and requires years to write proceedures to make it operational? Read more
Published on January 27, 2012 by Rob Ollivier
4.0 out of 5 stars Heavy on Facts, One Chapter is Out of Place
One of the most compelling reasons to read Health Care Will Not Reform Itself is the fact that it is written not by an academician, politician or even a doctor. Read more
Published on November 28, 2011 by Matthew Theisen
5.0 out of 5 stars Health Care Will Not Reform Itself
It is a short read compared to most books on this subject. The book is crisp and focused right on all aspects of our problem with health care in the United States. Read more
Published on July 20, 2010 by ed glasser
5.0 out of 5 stars Can you get there from here?
I'm a satisfied user of K-P Mid-Atlantic, Medicare component.

I moved from rural Virginia two years ago where I experienced good, but fragmented medical care,... Read more
Published on May 14, 2010 by Tidewater
5.0 out of 5 stars Outstanding, Easy to Read -
"Health Care Will Not Reform Itself" presents documented and logical approaches to improving America's health care 'non-system. Read more
Published on April 1, 2010 by Loyd E. Eskildson
3.0 out of 5 stars Interesting but misses the biggest question not being asked.....
This is a really thought provoking book with some excellent points.

Was a tad puzzled why Chapter 9 was only a handful of pages long and discussed issues like Americans... Read more
Published on September 29, 2009 by Beth DeRoos
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