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Oxymorons: The Myth of a U.S. Health Care System 1st Edition

3 out of 5 stars 8 customer reviews
ISBN-13: 978-0787959708
ISBN-10: 0787959707
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Editorial Reviews

Review

"In his first book "Bleeding Edge," and his editorials in The Wall Street Journal and elsewhere were his argument on behalf of managed care, then "Oxymorons" is his mea culpa." (The Wall Street Journal, 12/11/01)

"The book is interesting, easy to read, and flows smoothly." (Journal for Healthcare Quality, October 2002)

Review

"J.D. Kleinke takes us on a fearless, often harrowing journey to the beating heart of the U.S. health care system, dispelling much of the conventional wisdom about what is wrong with that system, and focusing our attention on what will and will not work to fix it. Oxymorons is a comprehensive, uncompromising, and durable milestone in the annals of health policy, medical, and business literature." — John Iglehart, national correspondent, New England Journal of Medicine and founding editor, Health Affairs
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Product Details

  • Hardcover: 272 pages
  • Publisher: Jossey-Bass; 1 edition (September 27, 2001)
  • Language: English
  • ISBN-10: 0787959707
  • ISBN-13: 978-0787959708
  • Product Dimensions: 6.4 x 0.9 x 9.3 inches
  • Shipping Weight: 1 pounds (View shipping rates and policies)
  • Average Customer Review: 3.0 out of 5 stars  See all reviews (8 customer reviews)
  • Amazon Best Sellers Rank: #1,933,467 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

Format: Hardcover
Oxymorons is an outstanding book. It is very well written, interesting, comprehensive and insightful.
Kleinke makes a compelling case of what is wrong with our employer-based health care system (which he calls dysfunctional). He argues that the best answer for the U. S. is to get employers out of the picture and come up with a counsumer-choice plan (through tax credits or other means, consumers purchase their own health plans).
I especially liked Chapter 9 where Kleinke reviews where he is coming from. For a period of his life, he and his wife could not afford health insurance and were among the ranks of the uninsured. He tells what it is like to scrounge for antibiotics to fight a serious sinus infection, and other experiences in trying to receive health care without the ability to pay. Naturally, he is strongly in favor of some form of coverage for the 44 million people in the U. S. who are uninsured.
In the last sentence of the book, Kleinke says that only three elements in health care really matter -- patients, caregivers and medical technologies, including new drugs. I would add money, or finance. It seems to me that the payment system is the primary driver of the fragmentation we are experiencing, and that most proposals for change in health care relate to financing.
In conclusion, Kleinke has written a valuable book, and one that should generate plenty of discussion among those interested in the future of health care in the U. S.
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Format: Hardcover Verified Purchase
J.D. Kleinke uses 90% of the book to describe the woes of the US healthcare system. The tone is very very negative and the author uses words such as "moronic" way too much. It is tiring to read so much unbalanced negativism. The critique may be warranted but is not properly structured; there is a lot of focus jumping from anecdotes about payers, providers, government, consumers, consultants, etc. Kleinke even tries to explain the problems using Complexity Theory about which he clearly knows nothing. (Attempting to draw analogies between our healthcare system and sets of stiff differential equations). In the last 10% of the book Kleinke presents a solution that he does not tell how could ever be implemented. It is a combination of old utopic ideas. In short, buy this book only if you need more reasons why our healthcare system is broke.
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Format: Hardcover
Oxymorons is the first book that dares to look at the whole mess that is the US health care system without a political or business agenda. The author explains exactly why the system is stuck in political and economic gridlock, and how this gridlock actually benefits all those denouncing it the loudest - the health insurance companies, consultants, lawyers, and various business schemers who make money on the system's complexity and dysfunction. After discrediting so much of the nonsense that pundits and policy types like to generate about health care using real data, Oxymorons then dares to put forth a concise and simple plan for how the federal government and a non-governmental non-partisan health benefits task force (notably not any one state government or any newfangled managed care scheme) can change a few simple rules, establish some actual standards, and flush out a lot of the waste that defines the non-system of health care in the US. Kudos to the author for calling it like he sees it, and still having the guts to propose a real solution.
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Format: Hardcover
Kleinke's book is itself oxymoronic. He complains that the current "system" is not a normal market, but that by placing purchasing power in the hands of "consumers," a normal market will emerge. WRONG. With rare exceptions, it is the supplier of medical services who determines the level of demand for those services. Compounding this perversion of ordinary market forces are two other significant realities: a). If potatoes are being purchased, the consumer would have a knowledge of the product and of its value that is fairly equivalent to the knowledge of the grocer. In medicine, the "consumer" usually has nothing approaching equivalent knowledge about the services to be provided, and must rely entirely on the word of the physician about the value of those services; b). The physician workforce in the U.S. is currently twice as large as would be optimal for the health status of the whole population, this according to an exhaustive study completed by the Pew Commission on the Health Professions, under the chairmanship of former Senator George Mitchell. The American people are paying for this huge oversupply in the physician workforce in lives as well as in money. Using publicly available Medicare data, the physician editors of The Dartmouth Atlas of Health Care have provided a specific characterization of the medical services that they have defined as being "supply sensitive:"
*Weak or absent scientific evidence for providing the service.
*Rather, care is provided under the assumption that more is better--or can't hurt.
*Use of the service is strongly associated with local supply.
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