Customer Review

29 of 40 people found the following review helpful
5.0 out of 5 stars Excellent Overview of U.S. Health Care, March 7, 2014
This review is from: Reinventing American Health Care: How the Affordable Care Act will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System (Hardcover)
American health care leads the world in costs - 18% of GDP (while excluding about 15% from insurance coverage), vs. 4% for Singapore (excluding no-one) at the low-end. It also infects 5% of hospitalized patients - of which nearly 100,000 die, and kills another estimated 44,000 - 98,000 from other hospital errors. Surely this complicated mess deserves rethinking. Unfortunately, getting from the mess we have now to something akin to the high-quality, much-lower cost care in Singapore, South Korea, Japan, and Taiwan has proven beyond the capability of America's legislative leaders. Decades of failed prior attempts, followed by compromise after compromise was required to even get the limited improvements afforded by the ACA when it was enacted in 2010.

Dr. Emanuel clearly likes the ACA - understandable given his role in its development. However, he minimizes trying to sell the ACA, doesn't mince words excoriating the initial ACA rollout efforts, and focuses on explaining our current complicated, dysfunctional system. I'm very hopeful that one of ACA's mandates (electronic medical records) will prove far more valuable than imagined, helping to identify important interactions, improve treatment protocols, and save lives. Improving access to care will also save lives. Similarly, encouraging the growth of accountable care organizations with bundled payments should also save lives and reduce costs by incentivizing quality improvement and removing incentives to over-treat. Finally, taxing 'Cadillac' plans will also hopefully make a dent in cost control.

An excellent and objective overview of complicated subjects
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Showing 1-2 of 2 posts in this discussion
Initial post: Mar 22, 2014 5:43:13 PM PDT
Well written review. Pointing out author's criticisms of something he helped create suggests this may not be the whitewash one might expect on such a politically charged subject. Definitely encourages me to get the book to find out.

Posted on Sep 1, 2014 7:50:48 AM PDT
T. Clarke says:
The problem with your statement "getting from the mess we have now to something akin to the high-quality, much-lower cost care in Singapore, South Korea, Japan, and Taiwan has proven beyond the capability of America's legislative leaders" is that you put the responsibility for the system on politicians. Some people think you can compare USA to other countries, but as many European nations are now finding out, when you have more than one culture/ethnic group/nationality to deal with, things get more complicated. Americans demand the newest, shiniest, tools and toys to treat their health conditions, but are fat and lazy. We bring much of it upon ourselves but expect someone else to pay for it. To compare the issues we have with our melting pot population with these small, homogenous countries with rice/fish based diets is misleading at best. And ACA does almost nothing to improve the system or address costs, only to increase access (which will increase costs) and handicap the small steps health risk management (wellness) programs have started to make on utilization.
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