Saving Lives & Saving Money [ILLUSTRATED] (Paperback)

This book posits that the single greatest problem (but by no means the only one) with our current healthcare system is the third party payor system that has arisen from the perverse incentives introduced into the tax code that have made employer provided healthcare the dominant organizational methodology in our country today. The effects of these incentives are exacerbated by the increasing share of medical spending being reimbursed through the government Medicare and Medicaid programs. Consumers of healthcare are frustrated because their choices are limited; providers are frustrated by the bureaucracy, paperwork and interference with their medical judgment as well as the lack of tort reform; and the funders (taxpayers and employers) are horrified by the rate of increase in their costs. One of the unintended consequences of these incentives is that the system treats illness much more effectively than it promotes health and personal responsibility for the consequences of your actions.

The book contains many interesting insights on the role of technology, not only in the administration and provision of more responsive service by providers and in recordkeeping that minimizes duplication of effort and decreases the prevalence of errors but also in the furthering of scientific advances themselves. The frontier of medical and scientific discovery today is at the intersection of chemistry, physics and biotechnology, and chapter nine provides some observations in this regard. The overall tone of the book is both urgent and hopeful, as the author clearly understands the huge political difficulties in changing such a complex system with so many different constituencies.

This book definitely a worthwhile read for anyone interested in a broadbrush approach by a serious student of the subject with the perspective that the author brings to the topic. However, the book suffers from some flaws. First, it is a collection of loosely connected chapters. They are somewhat sequential but can stand on their own. The disadvantage of this approach is that there is an incredible amount of repetitive material if one reads the whole book. While the emphasis of some of the points is appropriate, this is a mix of anecdotes, exhortation, well thought out proposals, interesting information, and moral outrage at the consequences of the perverse incentives of our current system (unnecessary death and suffering). Second, the former Speaker lapses into his habit of occasionally getting so excited about the potential impact of something that he believes it is necessary to mandate it at the federal level (e.g. an immediately accessible computerized database of all medical information for each individual) despite all the evidence that this will stifle creativity and curb further beneficial evolutionary developments. In addition to the very negative implications for our liberty.) Third and most discouraging, he proposes very large increases in federal spending in several areas, indicating his belief in market failure and his lack of faith that individuals and private industry will make the appropriate choices with regard to such areas as funding basic research, preventive treatment for diabetes, etc. Such suggestions seem at odds with the basic premise of this book, i.e, that informed consumers with the appropriate knowledge deserve the maximum amount of flexibility in their healthcare choices and need to accept as much personal responsibility in their consumption of healthcare as in other areas of their lives. Thus, while I want to encourage widespread readership of this book and discussion of its ideas, it does not deserve five stars.

Disclaimer: the author is a personal friend of mine, but he never requested that I review it and my copy was purchased at this site, not provided free to me. I serve on the Board of Directors of an organization which he once headed, and healthcare reform is one area that we both agree is crucial to our country's future, although we disagree on many aspects of various proposed reforms. We agree in the areas of public policy where my libertarian ideals intersect with his conservative principles, while strongly disagreeing in such areas as the decriminalization of many currently illegal substances. I believe that my review is objective with regard to this book but wanted the readers of this review to have all relevant information that might have influenced my recommendation.

Tucker Andersen

Filled with real life examples of transformational solutions and specific ways for all citizens to get involved in the healthcare debate, this book is a call to action. It provides one with an understanding of the problems of the current system, a vision for the future system and challenges one to get involved in the transformation. I am very interested in the Center for Healthcare Transformation that was mentioned as one way to get involved.

I recommend this book to private citizens and healthcare and IT professionals who want to transform the current system. I also recommend it to students of any health related discipline (nursing, medicine, health system administration to name a few) wanting to better understand the problems of the current system and the transformation that is needed.

Newt is a visionary and a gifted teacher. This book is an excellent blend of those talents.