We have been blessed recently with some wonderfully fresh health reform perspectives. 

First, we have several books about how we are over treating our patients—from Halvorson’s and Ishem’s Epidemic of Care and Halvorson’s book Health Care Reform Now, to Shannon Brownlee’s Overtreated, excellent cases are made and documented that the real culprit in health care is not the public’s perception that it is “managed care.”  The real culprit is fee for service—since no money changes hands without doctors doing something to the patient.  Ironically, there is no incentive or reward to keep us healthy.

We have Mike Magee, MD’s, book on Patient Centered Health Care, where he so beautifully paints a picture of what a truly patient-centered health system could look like. He relies heavily on technology, but as a former caregiver for an aging parent, his model of family centered care really resonated with me. I could actually see his model working in the not too distant future.   I think if more people read this book, they could actually see how a restructured health care system could work—something people tell us they will need it they are ever going to act for change.

Now we have Rx for Health Care Reform by Ken Terry.

While appearing lengthy at 350 pages, thanks to its formatting and style, it is still an easy read.  The chapter structures have a precision and logic to them that is clear to any reader.  In fact, this book is another must read for any thoughtful person trying to wade through health care reform. 

Terry clearly understands physicians and how their practices work, which is a critical to any understanding of what physicians need to succeed in a new environment.  And if they don’t succeed, health reform will ultimately fail.  He also understands the successes and failures of reform efforts in Hawaii, Massachusetts, California and Minnesota.  As senior editor of Medical Economics for the past 15 years, he has had the opportunity in a rare way to see the direct impact of changes on physician practices and hospitals. Consequently, he has had real life experience with reform in ways few people have.  As a journalist, he makes that experience come alive with vibrancy. 

Terry’s Rx for Health Care Reform is an interesting model.  Interestingly enough our market research in Washington and Iowa suggests the public might actually support such a model.  He proposes a public utility model—a shared responsibility of individual, employer and government.

I was quite taken by his “Loss of Tax Deduction” description. This is an issue that has eluded me for years.  Given that employers reap tax benefits by having their premium payments come from pre-tax dollars, I thought this would be one of the thornier issues in health care reform.  But Terry makes an excellent case about how a few simple revisions might work—and it makes sense. 

I have just dipped into the surface of the rich and thoughtful content of his book.  I highly recommend Rx for Health Care Reform.  We Americans are a pragmatic people who love to solve problems.  While I don’t agree with all his conclusions, he clearly has experience in both successful and unsuccessful reform efforts, and he understands the results of such efforts. 

Refreshing New Voices

There are more and more of us now hovering around some key issues and some areas of potential agreement.  While I am not sure all of us would agree on all of our proposals, various groups and individuals are coming up with relatively similar findings—that are for a change—pragmatically driven versus ideologically driven. 

I think exciting opportunities lie ahead in 2008. 

Next book review in the hopper:  Critical: What We Can Do About the Health Care Crisis by Senator Tom Daschle.

Cheers and more later.  Kathleen