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Healthcare, Guaranteed: A Simple, Secure Solution for America Paperback – May 26, 2008

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Editorial Reviews


Financial Times
"The best of recent books on this question is happily the shortest and clearest and comes out this month. I think it has the answer. The proposal laid out in Healthcare, Guaranteed by Ezekiel Emanuel ... has convinced me. Whether it will convince others is in doubt for reasons I will come to. But if you are going to read one book on the subject, make it Mr. Emanuel's."

The Spine
“How to Fix Healthcare: Readers may recall an article by Ezekiel Emanuel and Nobel Laureate in Economics Victor Fuchs in TNR a while ago about their truly brilliant and, in my view, ineluctable proposal for paying for basic health care in America. Some time later we alluded in an editorial to the provocation of their plan to all the other policy contortions that pass as the foundations of legislation. Zeke has now expanded this work into a book, Healthcare, Guaranteed, published by PublicAffairs. By the way, he has a PhD in political philosophy from Harvard and an MD from the Harvard Medical School, and is now chairman of the department of bioethics at the National Institutes of Health. Years ago, he started his career as an intern at The New Republic. What a story that would make: those who began right here. In any case, Clive Crook has written a rave review, a truly rave review of the book in Monday's Financial Times. Before you read the review and the book, you should know that at the base of the financial plan is a value-added tax. This is one value-added tax that you might like.”

Newsweek, June 1, 2008
"This Monday a modest little paperback will show up in bookstores offering a suggestion for health-care reform. It won't contain any wrenching human stories like those in last year's big health-care book, Jonathan Cohn's "Sick." It won't be accompanied by gonzo stunts à la Michael Moore's "Sicko." But "Healthcare, Guaranteed," by Dr. Ezekiel Emanuel, may nonetheless be the most exciting book yet to come out of the country's medical crisis. What it offers is a radical yet straightforward proposal, one a layperson can understand. If the complexities of health-care policy give you a headache, this book is aspirin. Read it twice and call your congressman in the morning."

Ezra Klein, American Prospect, August 12, 2008
Healthcare, Guaranteed is beautifully written. It describes many flaws of American healthcare with maddening clarity. Some of its building blocks should be included in anyone’s health plan”

New England Journal of Medicine, August 21, 2008
"Healthcare, Guaranteed is a broad discussion of pervasive problems in our health care system, and it lays out a comprehensive plan to remedy them...Policymakers and all Americans troubled by [the system's] injustices will find Healthcare, Guaranteed a valuable resource for considering solutions to our health care dilemmas."

New York Times, 33: Zeke and book featured in piece about Obama’s health policy team
“Another influential voice at the White House is that of Dr. Ezekiel J. Emanuel, an oncologist and medical ethicist. Dr. Emanuel, a brother of Rahm Emanuel, the White House chief of staff, is working for Mr. Orszag and is sometimes described as the kibitzer-in-chief on health policy….In a book published last year, for example, Dr. Emanuel proposed “a guaranteed health care access plan,” under which all Americans would receive vouchers to enroll in health plans offering a standard package of benefits like those available to members of Congress. The program would be administered by a National Health Board, modeled on the Federal Reserve Board….”

About the Author

Dr. Ezekiel Emanuel is the Chair of the Department of Bioethics at the Clinical Center of the National Institutes of Health and a breast oncologist. A visiting professor at the UCLA, John Hopkins Medical School, and Stanford Medical School, and the author of several books, he lives in Evanston, Illinois.

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Product Details

  • Paperback: 240 pages
  • Publisher: PublicAffairs; 1 edition (May 27, 2008)
  • Language: English
  • ISBN-10: 1586486624
  • ISBN-13: 978-1586486624
  • Product Dimensions: 0.8 x 5.5 x 8.2 inches
  • Shipping Weight: 11.2 ounces (View shipping rates and policies)
  • Average Customer Review: 3.9 out of 5 stars  See all reviews (25 customer reviews)
  • Amazon Best Sellers Rank: #938,308 in Books (See Top 100 in Books)

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Customer Reviews

Most Helpful Customer Reviews

54 of 58 people found the following review helpful By Bookworm on February 1, 2009
Format: Paperback Verified Purchase
This book came highly recommended to me as a practical, non-ideologically driven approach to our present healthcare delivery system woes. I agree with Dr. Emmanuel that our present system is not sustainable and will bankrupt our country if we continue on our present path. His analysis of our present system, its history, problems with employer based systems, and alternative approaches including mandate and single payer approaches is well written.

His ideas for how an ideal system might be constructed de novo are not without merit. However, his prescription for how to arrive at such an outcome is terribly flawed.

The book describes using private insurance companies which will compete for the business of every American who will receive a health care certificate, However, to avoid our present circumstances, Dr. Emmanuel proposes the creation of an entirely new infrastructure consisting of both national and regional boards which will be charged with ensuring quality of care, appropriateness of care, coordination of care, cost control, fair funding, dispute resolution, and choice. Dr. Emmanuel likely made a tactical decision to write a focused book without getting bogged down in details and at least some criticism could be deflected on this basis. However, this entire proposal is based upon infrastructure which does not exist and is not likely to come into existence for a long time.

Not only do organizations, which would be charged with these various tasks, not exist, the tools they would need to function would require years of investment and study. Outcome measures such as life or death or surrogate measures linked to the same (blood pressure, blood sugar, weight) are fairly easy to measure. As Dr.
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28 of 32 people found the following review helpful By JRT on June 6, 2008
Format: Paperback
If the United States hasn't passed the threshold of interest in health care reform, it must be darn close. Thus, now is the time for a clear and concise argument for any particular approach. Dr. Emanuel puts forward a specific proposal for health care reform that would address the seven goals he views as essential to success. His proposal has a strong appeal to common sense, and as such, it is one that will surely suffer the slings and arrows of outrageous ideologs. But, besides presenting his own distinct proposal for reform, Dr. Emanuel gives enough background on our present plight, along with a heuristic tool to equip us to evaluate the many different reforms out there already and the many yet to come. And, he does this without resorting to the use of extreme case histories, which have become the coin of the realm for authors of books on health care reform and which can have distorting effects on any objective analysis. Even members of Congress will not be able to get away saying they do not understand the concepts in this book.

This is an important book at an important time, and one that invites everyone into the health care reform debate whether they agree with Dr. Emanuel's proposal or not (count me among those who do). But, alas, important as this work is, it would never get Dr. Emanuel tenure at a major research university; it's much too accessible. He'll have to keep his current job.
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26 of 32 people found the following review helpful By Wendell Murray on June 23, 2008
Format: Paperback Verified Purchase
Dr. Emanuel has been writing for some time on the subject of health care policy, usually in collaboration with Prof. Victor Fuchs, an eminent, but now-retired, health economist. Prof. Fuchs collaborated with Dr. Emanuel on this book, as Dr. Emanuel notes in it, but apparently the final version as published is mostly the work of Dr. Emanuel.

This and two other books that I highly recommend on health care policy, A Second Opinion and Health Care Policy, are written by physicians who know the science and practice of medicine as well as the economics of medical services. Another, also very good, book, Health Care Half Truths, is co-authored by a physician.

The book is fairly short, very well-written and well-organized. Dr. Emanuel spends the bulk of the book analyzing the current medical services delivery (and to a lesser extent the funding of the system), then at the end of the book makes cogent recommendations on reform.

Although my personal opinion on the particular form that the financing of medical services should take (I strongly favor a single payer/insurer scheme) differs from Dr. Emanuel's view, Dr. Emanuel presents compelling evidence why a single payer/insurer scheme is inferior to his recommendation: a voucher system that is funded by a dedicated value-added tax. Dr. Emanuel recommends the continued existence of private health insurers, asserting that their presence furthers choice and potentially at least engenders competition. My perspective is that private insurance simply has no place in a medical services system. The forces that drive private health insurance companies are immutable. Private insurers inevitably increase the administrative cost of effecting payment for services. They also have no ethical role as deciders of what treatment should occur.
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6 of 7 people found the following review helpful By Danioton on November 27, 2009
Format: Paperback
A very disappointing book. It's comes down to a list of talking points, overly generalized and mostly wishing away reality without engaging with it.

And this is not the plan working its way through Congress.
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