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25 of 27 people found the following review helpful:
5.0 out of 5 stars
Howard Dean Writes it Right, July 11, 2009
This review is from: Howard Dean's Prescription for Real Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer (Paperback)
Healthcare reform plays a major role in discussions and the media today, but it is confusing, overwhelming, boring and seemingly unsolvable to most people. Howard Dean presents the problems and solutions in plain language in his new book, Howard Dean's Prescription for Real Healthcare Reform. For Dr. Dean's appearance schedule please visit the publisher's website.
Hear someone utter the word Healthcare and the emotion that rises up and continues to spiral nearly out of control is anger. Dean writes, "according to a recent report from the Center for American Progress, in March 2009 alone almost 11,000 workers a day lost their health insurance." Do the math and the anger turns to outrage - 341,000 people lost their health insurance in a 31-day period.
There are "47 million Americans who don't have health insurance. But the healthcare debate should also focus on the fact that 25 million working-aged Americans have health insurance but still cannot' afford to see a doctor," states Dean in his introduction. Terrifying statistics compounded by information from the Commonwealth Fund, "many go without needed care, not filling prescriptions, and not following up on recommended treatment."
Howard Dean is eminently qualified to write about healthcare reform for several reasons. He is graduated from Yale in 1971 with a BA in Political Science. He received his medical degree from Columbia University during which he spent one month at the American Medical Association following Senators Jacob Javits and Ted Kennedy as they attempted to create a healthcare bill during President Carter's first term. His was elected the first Democratic Governor of Vermont since 1853. His efforts during his Governorship insured that 99% of Vermont citizens under the age of 18 had access to healthcare coverage, expanded prenatal care, community health centers and dental clinics in schools serving low-income children.
But it is his one simple statement at the end of the preface that says it all. "All change grows from the grass roots. Real healthcare reform won't happen without you." He is clearly directing his thoughts at the everyman/woman - he is writing for the people who need healthcare insurance or worry that their insurance will come to an end due to loss of job or steep rate increases.
Dean clarifies, finally a politician that realizes what the people want to hear and how they want to hear it, the difference between healthcare reform and health insurance reform. "So, the real debate about healthcare reform is not a debate about how large a role government should play. The real issue is: Should we give Americans under the age of sixty-five the same choice we give Americans over sixty-five? Should we give all Americans a choice of opting out of the private health insurance system and benefitting from a public health insurance plan?"
He further states, brilliantly making his point absolutely current, "Americans ought to be able to decide for themselves: Is private health insurance really health insurance? Or is it simply an extension of thing that have been happening on Wall Street over the past five to ten years, in which private corporations find yet new and ingenious ways of taking money from ordinary citizens without giving them the services they've paid for?" Does the Madoff ponzi scheme ring a bell here? Money invested with absolutely no return on investment not to mention complete loss of all funds. Who hasn't paid for insurance month after month and not received coverage when they needed it the most?
Dean details the profit vs. care issue and succinctly discusses the problems with private, for-profit insurances companies that "must meet two obligations that are often mutually exclusive." These private behemoths are responsible for maximizing profits for their shareholders while shouldering the responsibility for good service to their customers. Is this even possible given the way private health insurance companies are structured coupled with the lobbyists who ensure that they have more or less free-reign with blatant disregard for the welfare of their enrollees.
Chapters cover the trials of small business owners and individuals and uses real-life examples to drive home the point. He strongly states that "America most shift from an illness-based healthcare system to a wellness-based model." He writes of the necessity to change the national lifestyle toward one of prevention and healthier living. A goal that neither political party nor business or individuals could argue with - who wouldn't want to be healthy?
Dean covers the challenges briefly but completely and spends a good portion of the book providing solutions. "Americans need real healthcare reform, not just insurance reform, and nobody should mistake the two," he states. "Real healthcare reform should offer coverage to the employed, the unemployed, the sick, the healthy, the young, the old. Everyone."
He puts forth five sound and achievable principles that "real healthcare reform must include." Everybody In, Nobody Out; No more Healthcare Bankruptcies: Take it to Go; Choose or Lose and Improved Care, Quality and Efficiency. He reviews President Obama's healthcare initiative; how to control costs; developing a revenue stream to pay for the initiative; and "who's been standing in the way."
Dean avows that change is possible through the citizens, calling for change and action. He writes of how this affects people in different walks of life and details, "What you deserve, and should fight for." He staunchly recommends how citizens can and should take action; educate themselves; contact their local and national officials; contact corporations and organizations and keep the conversation going until change happens.
The last sentence makes Dean's position clear, "Fights like this are won by ordinary people who decide that they care enough about something to fight for it." Prescription for Real Healthcare Reform should be required reading for every American over the age of 18. This is the most comprehensive and accessible presentation of a situation that deeply affects each one of us.
About the author:
Physician Howard Dean is the former chairman of the Democratic National Committee. He served six terms as Governor of Vermont and ran for the Democratic Party's presidential nomination in 2004. Dean founded, Democracy for America, a grassroots effort that organizes community activists, trains staff and endorses progressive candidates.
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14 of 14 people found the following review helpful:
4.0 out of 5 stars
Good Medicine for Skeptic and Enthusiast Alike, July 29, 2009
This review is from: Howard Dean's Prescription for Real Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer (Paperback)
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So that you know my point of view: I'm a 56 year old family physician that has practiced on Indian reservations, in clinics that cater exclusively to Medicare and Medicaid patients, and for the last 14 years, in a private practice group of eight doctors in a small town in Central Oregon.
Howard Dean's Prescription for Real Healthcare Reform is an even-handed, even-tempered, well researched investigation of what options we Americans face regarding the future of healthcare in our country. With none of the stridency of either the free market advocates or the single payor systems devotees, Dean lays out some indisputable facts, and offers thoughtful solutions to decreasing costs. Here are some basics, all of which have been documented thoroughly elsewhere: the United States spends 15% of its Gross Domestic Product (GDP) on healthcare, 50% higher than what our allies France and Canada spend, 40% higher than what Switzerland spends. For this, we get a product that is ranked last in quality, access, efficiency, and health of citizens as compared to our European and Canadian counterparts. This isn't a liberal problem, or a conservative problem. It's a humiliating problem for a physician like myself that takes pride in my country and my profession. And it's a problem that I seeing play out in real life every day that I show up to work. It flies in the face of our image of ourselves as a can do, innovative people.
Dean's short (115 pages of fairly large print) book is a bit dry, reading somewhat like a lengthy white paper on healthcare reform. Dense in information, engaged but not enraged, Dean lays out solutions that have worked internationally much better than our own haphazard approach to national healthcare, yet solutions that Americans might improve upon with our hallmark ingenuity, inventiveness, and commitment to competition in the marketplace. He does NOT advocate a single payor system, he DOES insist that we need a "government based option". Option, as in Dean's belief that Americans insist on choice, and his belief that a single payor option that would compel Americans to belong is a non-starter.
If you're an archetypal "bleeding heart liberal", you'll get little sympathy from Dean: he's a pragmatist that bluntly advocates a practical approach to good bang for the buck healthcare for all. If you're a free market fanatic, you'll find out why the captains of industry (e.g. automakers) are crying "Uncle!" or "Uncle Sam!" to get out from under the $1400 per car cost of their employee health insurance. You'll also find out that Medicare spends about 10% of its revenue on administration, versus double that in the private insurance industry, and achieves markedly better results than private industry health care insurance.
In short, Dean's book provides a useful framework for the debate regarding what to do about an overly expensive, poorly performing, industry injuring, health care system, regardless of your political persuasion.
Am I willing to take a personal hit in my paycheck as a physician to see reform come to the U.S? You betcha, as in yesterday. Especially if they force me to take the salary those poor primary care blokes in the United Kingdom make: $220K/year. Which is roughly TWICE what I make here in rural U.S.A. :-))
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9 of 9 people found the following review helpful:
5.0 out of 5 stars
I really learned a lot, August 13, 2009
This review is from: Howard Dean's Prescription for Real Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer (Paperback)
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Howard Dean's Prescription for Real Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer
I thought I was a little smarter than the average bear when it came to understanding healthcare reform, since I worked in employee benefits for more than 10 years in the 70s and 80s when cost-containment (but not yet issues of denied coverage) had just become a major issue. However, I still learned quite a bit from Dr. Dean's book about the past history of healthcare reform, what is included in Obama's plan, and what other countries do. I highlighted huge portions to quote for my blog on healthcare reform.
Though obviously put together quickly, including a few typos and awkward sentences, it is still quite interesting and easy to read. At the same time, I'd say it is as objective as it needs to be in this fight that has turned into a shouting match. When opponents of reform are spouting outright lies--which they are--there isn't room for much deference. On the other hand, what some are touting as a plan from the far left, actually pays great homage to our free enterprise system. Dean repeats over and over that Americans wouldn't accept a plan without choice, though I'm not so sure that is true.
However, as originally a strong advocate of single payer, I was amazed to learn that most of the countries providing universal healthcare are not single payer but a system of competing private plans with guaranteed coverage and community rating with most either providing some form of public option for those who can't afford private coverage or a mandate on what private insurers can charge. As I can't see anyone in this country accepting regulation of what a private insurer can charge as premiums, the public option now appears to me as the most reasonable way to go.
I was a little vague on how much of what Dean outlines is actually part of the Obama reform plan and how much is what he, Dr. Dean, would like to see. But there's no doubt that, as a physician and former governor who successfully reformed Vermont's healthcare system, he is knowledgeable on the subject and his ideas should be considered seriously.
Even if you think you already know where you stand on this subject, I suggest you read this book. It could change your mind.
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