Book Description
Health Economics and Policy is a basic introduction to the microeconomics of health, health care, and health policy. This edition demonstrates how economic principles apply to health-related issues. It explains the social, political, and economic contexts of health care delivery and explores the changing nature of health care. Students learn to analyze public policy from an economic perspective. While the text was written for non-economics majors, it includes enough economic content to challenge majors.
Customer Reviews:
EXCELLENT.......2005-03-22
I had the pleasure of taking this class from the author of this class. Dr. Henderson is not only absolutely excellent teacher, he is an equally good writer. I was not an economics major, and was somewhat fearful about taking "Economics of Medicine" as a class, but this book is thorough, organized, and easy to understand. It is an excellent book for economics majors as well as those majoring in other health care related professions who have an interest in learning more about the current health care system and related policies.
Average customer rating:
- Excellent analysis with some weak points
- Redefining Health Care
- A new look
- Disappointed but Some Might Find Value
- Redefining Health Care
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Redefining Health Care: Creating Value-Based Competition on Results
Michael E. Porter , and
Elizabeth Olmsted Teisberg
Manufacturer: Harvard Business School Press
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ASIN: 1591397782 |
Book Description
The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing costs--not to mention the stability of state and federal government budgets.
In Redefining Health Care, internationally renowned strategy expert Michael E. Porter and innovation expert Elizabeth Olmsted Teisberg reveal the underlying and largely overlooked causes of the problem and provide a powerful prescription for change. The authors argue that participants in the health care system have competed to shift costs, accumulate bargaining power, and restrict services rather than create value for patients. This zero-sum competition takes place at the wrong level--among health plans, networks, and hospitals--rather than where it matters most: in the diagnosis, treatment, and prevention of specific health conditions.
In spite of competition among these systems, the patient care cycle is poorly coordinated. The fractured system undermines both efficiency and quality of outcomes.
Redefining Health Care lays out a breakthrough framework for redefining health care competition based on patient value over the full cycle of care—from prevention and diagnosis through recovery or long-term disease management. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move to value-based competition on results that will unleash stunning improvements in quality and efficiency.
Customer Reviews:
Excellent analysis with some weak points.......2007-09-01
This book has received probably disproportionate attention due to Prof. Porter's notoriety as a strategic thinking theorist. There are better overall books on healthcare policy available. In particular I recommend the Bodenheimer/Grumbach books, one on healthcare policy and one on primary care, Dr. Arnold Relman's book, A Second Opinion, Strained Mercy, an outstanding and thorough analysis of healthcare economics with particular regard to Canada's healthcare system, among others.
I find the analysis of the USA healthcare system by Profs. Porter and Teisberg to generally be excellent, although I find it wanting in regard to their disparagement of a single-payer/single-insurer system and to their description and analysis of healthcare systems outside the USA. From my perspective private health plans play only a net negative role in the system. The authors' analysis of how the health insurance market works is quite good. However their recommendation that a system of private insurers should persist is refuted by their own analysis! A single payer/insurer system will not cure the problems of the US system, as they clearly point out, but it does remove the inherently dysfunctional characteristics of private insurance, not least of which is its failure to meet the needs of the uninsured - a very large number - and its inherent propensity to exclude the very people who need coverage and care. The authors rightly point out that mandatory health insurance along with risk-pooling among insurers to spread the costs of those insured individuals who generate the highest costs is a "solution" to the current non-functioning system, but the same result, at lower cost and with much greater simplicity, can be achieved through a single payer/insurer.
The other key aspect of healthcare - how it is delivered - is ultimately more important than the financing/insurance side. The authors provide excellent analysis and recommendations in this regard. They correctly address the aspects of the healthcare market that prevent its functioning as a "competitive" market, specifically the abysmal lack of patient information on prices for services, on outcomes of actions by providers, comparative statistics on provider performance and similar. They also provide an interesting report by the Cleveland Clinic on outcomes, i.e. results, of the Clinic's heart surgery activity. They appropriately use this as an example of the kind of reporting that is needed.
The authors' analysis of healthcare systems outside the USA is skimpy and inaccurate in my opinion. The authors underplay the demonstrated efficacy of government-funded systems that outperform the USA system almost across the board in gross measures of outcomes (infant mortality and longevity) and vastly outperform the US system in regard to cost. They gloss over the fact that per capita costs in the USA are 2.5 times! the average of other OECD countries. It is not as though the costs are say 10% above the average with comparable outcomes. They are 150% higher with worse outcomes. Instead of noting this and analyzing it thoroughly, the authors assert that waiting times and rationing of care are significant problems in those countries, assertions which are simply not borne out by a closer examination of the facts. Also the fact that (mostly) single-payer/insurer systems function well universally does not fit the authors' main thesis, so rather than revise the thesis based on this evidence they choose to ignore the evidence.
As a consequence of these limitations I rate the book with 4 stars rather than 5. Too bad, because most of the book is excellent.
Redefining Health Care.......2007-05-23
Book Review
Redefining Health Care by Michael Porter
I am writing this review to help share some excellent ideas on the availability and quality of medical treatment in the United States and on the U.S. economy which is being dragged down by ever-increasing medical costs. The economic impact is not just on corporate profits and stock prices but also on U.S. employment because everything that raises costs makes it harder for U.S. manufacturers to compete with foreign suppliers and makes it harder for U.S. manufacturers to sell in foreign markets.
Unfortunately, the book is long, turgid, and full of details, which help to substantiate his conclusions and also provide guidance on implementing improved policies. I am afraid the book does not appeal to executives, politicians, or doctors. It also proposes radical changes in all aspects of the medical system and its financing and operation. Dr. Porter proposes major changes on the part of all parties involved in delivering and paying for health care.
The book begins with a review of health indexes and health care throughout the world and shows, while the U.S. has the greatest expenditures by any set of measurements, it does not have the best results.
Then, Dr. Porter introduces his most important concept: that any medical treatment should be measured by its results; how much lost time and discomfort did the patient have, is he or she completely cured, or how much disability measured over the entire span of the illness or even the life of the patient. We tend to think of an operation as being successful if the patient left the hospital in good condition. But how much additional recovery time, disability, or reoccurrence was there? If the patient doesn't come back to see him, a doctor doesn't know whether he was cured by the treatment or if the patient was so dissatisfied he went to another doctor or simply gave up on a series of treatments. The goal is to develop a scoring system for each group of illnesses that can be compared with the cost of each individual's treatment and their results to determine what is the best set of procedures and the best doctor or group of doctors to do the work can be used to guide providers and treatments. Porter has some reason to believe that the best treatments are generally less costly even though the individual item costs may be more, the greater effectiveness and the less chance of complications reduces overall cost. Included in the overall cost should be lost wages, which is a reasonable proxy for the patient's time.
The goal is to develop a health plan that pays for results not for treatments. In many cases, that would be a single payment to the provider for a whole series of treatments from diagnosis on through operations, post-operative care, and follow ups which could extend over a long period of time. This is a radical change from the present system which pays for treatments and tends to produce more treatments and does not have any effective means for either the insurers, or the employers, or the patients even to compare one treatment option with another. This is an extreme, radical change and would take a long time to implement, but there are pieces of the program in operation. A number of these are explained at length. Health insurance companies could hire these firms for their specialized expertise and would not have to do the work on their own. An example of what is done is how the firm studies the history of heart transplant patients and will give an insurance company a single payment for the entire course of treatment providing it is done in the manner and by people they specify. They would particularly focus on caregivers who have an outstanding record of success. It appears that for most illnesses, there are organizations that are substantially better than others and this program could be extended broadly.
Another area of development would be to have counselors which would be part of the function of the insurer to advise a company's employees with a list of particularly well qualified doctors and suggest treatment elements.
Government would seem to be poorly adapted to facilitating these changes because they are radically different from Medicare. Medicare seems to promote cheap, but not necessarily effective treatments and set arbitrary pay scales which do not allow the better providers to charge more for their services and thus encourage more providers to be in the high performance category. Companies that pay for the insurance are the ones that have to put pressure on the insurers to implement the above changes. This could not be done over a short period of time but would eliminate a lot of the wasted time that is now involved in the payments for each little step of the process and for each treatment step.
Chapter 8 is a detailed discussion of how to implement the aforementioned concepts using modifications of Medicare and other laws. This is too complex to summarize here but it appears doable if Congress and the Executive are sufficiently motivated. It is likely that few people would understand what is happening, but the benefits to cost ratio is sufficiently great that the changes would probably be supported and accepted. On the other hand, the situation is so complex, it is questionable whether lawmakers and administrators would be willing to undertake the many complex tasks required. On the other hand, the downside risk appears quite small.
Porter approaches the whole subject from the points of view of business strategy and the problems of decisions with very imperfect information. While the government frequently acts with very imperfect information, its strategy for doing so is not well developed and poorly applied.
Redefining Health Care: Creating Value-Based Competition on Results
A new look.......2007-05-20
Though a little dry, and at times repetitive, this book offers practical information. In a mess of books describing the massive problems in healthcare today, this book was at once motivating and up-lifting. I bought it for a class, but it is one of the books I'll be keeping instead of passing along at the end of the quarter.
Disappointed but Some Might Find Value.......2007-04-05
I'm a big fan of Porter, but I was somewhat disappointed by this book. Let me be frank. The first problem I have with the book is that the authors try to capture as large of an audience as possible, being careful not to place blame on certain providers within the health care system. That approach might get better reviews and sell more copies, but it is not delivering real value. One cannot escape mention of the realities of corruption and fraud by every player in health care and expect to address the problems.
The second problem I have is that Porter fails to recognize that health care is distinct from any other industry in America because it is highly politically influenced. Much of the health care system is public (government funded). This is a main reason why competition in this industry is highly ineffective. How can you have a pure competitive environment when poor performing providers continue to receive government-funded contracts? How can you have full competition when Washington merely fines providers for fraud with no jail time? How can you have competition that creates value when Washington places the burden of increasing costs upon taxpayers, letting the industry charge what it needs to deliver earnings that Wall Street expects?
Overall, by failing to address the harsh realities of politics and big money within America's health care industry, Porter's book is too idealistic and therefore falls short of offering a real solution. Regardless, it is a quality book and at least does what no other has in trying to approach the problems from a reasonable standpoint. I expected more from him, but clearly this book is a view from academia and is far detached from many realities of big industry in America. There are many good points in the book, but without addressing the main problems of a system whereby lobbyist groups who control health care policy, very little will change.
Redefining Health Care.......2007-01-09
Overall the book is a very good essay on how our healthcare system needs to evolve. From my vantage point, many of the points are relevant. It is a relatively lenghty book, being 400 pages, but the book does have a good, logical flow. It is worth reading to better understand our current healthcare system and ways to improve it.
Book Description
America's leaders say the economy is strong and getting stronger. But ordinary Americans aren't buying it. They see what the rosy statistics hide: We are all struggling under the weight of terrifying economic instability. No matter how well educated and hard working we are, we know that the bottom can fall out at any moment. Meanwhile, the safety net that once protected us is fast unraveling. With retirement plans in growing jeopardy while health coverage erodes, more and more economic risk is shifting from government and business onto the fragile shoulders of the American family. In The Great Risk Shift, Jacob S. Hacker lays bare this unsettling new economic climate, showing how it has come about, what it is doing to our families, and how we can fight back. Behind this shift, he contends, is the Personal Responsibility Crusade, eagerly embraced by corporate leaders and Republican politicians who speak of a nirvana of economic empowerment, an "ownership society" in which Americans are free to choose. But as Hacker reveals, the result has been quite different: a harsh new world of economic insecurity, in which far too many Americans are free to lose. The book documents how two great pillars of economic security--the family and the workplace--guarantee far less financial stability than they once did. The final leg of economic support--the public and private benefits that workers and families get when economic disaster strikes--has dangerously eroded as political leaders and corporations increasingly cut back protections of our health care, our income security, and our retirement pensions. Hacker concludes by advocating an "insurance and opportunity society" that would safeguard economic security and expand economic opportunity, ensuring that all Americans have the basic financial security they need to reach for and achieve the American Dream. Jacob Hacker brings into focus as never before the pressures that the Great Risk Shift exerts on our pocketbooks and on our lives. Blending powerful human stories, big-picture analysis, and compelling ideas for reform, this remarkable volume will hit a nerve, serving as a rallying point in the vital struggle for economic security in an increasingly uncertain world.
Customer Reviews:
A book to avoid out of respect to fellow taxpayers.......2007-07-30
My book came, and I flipped through it to the last chapter--the REAL reason why I got this book.
While I knew this was a whiny tome about how people are being expected to shoulder more and more of their own social burdens, the title did contain a "how you can fight back" clause.
Well, the so-called "fighting back" involves exchanging one set of social programs for another, for example:
Medicare--of course, this would become Universal Health Care.
Retirement--instead of the accounts we have now, there'd be a Universal Savings account invented to take it's place. This account would cover any kind of savings you can imagine--retirement, college, etc., and would take the place of the ailing Social Security program.
Welfare--another magical account would be created to cover "insecurity": periods of unemployment, downshifting or pay cuts, high inflation, death of a working spouse, etc. to take the place of the existing food stamp, AFDC, unemployment, and/or disability. This would become Universal Insurance.
In short, the author proposes turning America into a highly-taxed, highly-coddled state like Denmark, where all is provided at taxpayer expense (up to 80% of people's pay), and only enough is left for housing, food, gas, and fun (like there'd be any fun on THAT plan!). Where would low-income earners come up with the money for THIS plan?
A quick calculation reveals that we couldn't even afford to pay rent on the 20% of our remaining income, let alone eat and commute, on our middle-class income with this plan.
Taxpayers would contribute to the new accounts, and the government would administer them just like it does now, except that your dollars would have your name on them. Personally, my dollars have my name on them now with my own private accounts, and I'm not paying for something I don't want or need.
There are solutions to these problems in existence now, but few are able to (or choose to) take advantage of them. This plan would take the choice out of the equation, and as far as I can see, doesn't account for the entrepreneurial spirit or self-employment.
If you prefer being self-sufficient, self-reliant, personally responsible, and to live below your means, then stay away from this book. There's nothing here for you except anger. This plan is clearly geared for the mindless sheep out there who want something for nothing, only this plan shows how dear the cost of that something would be--we're already paying up to 40% of our incomes in various taxes just to support people and government now!
What got us into trouble as a country is the fact that government borrows against assets--what's to say the government won't borrow against THESE assets as well? I don't want my accounts to be used as collateral by Uncle Sam.
Where oh where is the INCENTIVE to improve one's self, dear author? This is what got the "have-nots" into the position they're in now!! We've been leading horses to water for so long, they now expect us to bring it to them--and we STILL can't make them drink.
Rising Inequality and Anxiety in America.......2007-05-11
This past fall I heard Jacob Hacker speak about his work in The Great Risk Shift, and I just finally got around to reading the book. What I like about Hacker is that he not only critically examines complex political and societal issues, but he beautifully transforms his conceptions into practical solutions. He doesn't just ask, "What can we do?" He shows us how it can be done.
There are points I agree with in his book and other points I still have some reservations about, but his explanations and reasoning is thoroughly engaging nonetheless. For instance, he proposes a health coverage plan that reemphasizes national concerns about health care security. His proposal places more obligations on employers, which in my opinion, is a plausible expectation if the United States is not willing to adopt a universal health coverage plan. Hacker points out that a large contributor to the rise in bankruptcies is a result of healthcare costs. It's clear that health care insecurity poses great risks to countless Americans from all different placements of the socioeconomic spectrum.
I did face some apprehension and concern regarding his "universal insurance" proposal. This insurance would be designed to protect families in the event of a threatening change in finances and security - for instance a drastic pay decrease. Although I can agree that current job market conditions are very unstable (I myself have faced a drastic pay decrease formerly working in the business sector), I also feel as though we generally have a highly exaggerated sense of materialism and pretentious consumption patterns in America. How will these factors be accounted for when claiming instability and who is entitled to what? Is this where federal money should go when much larger issues regarding our nation's schools, health and extreme poverty are being neglected?
In the Great Risk Shift, Hacker identifies significant points of concern for Americans and the anxieties and rising inequality pressing citizens. With higher and higher concerns, these are questions we will be continually readdressing for years to come. This book proves Hacker always has amazing ideas and great things to say. We can contiunally look forward to his new approaches at examining significant social and political issues.
An attempt to ameliorate economic volatility.......2006-12-16
Although Jacob Hacker exaggerates the level of risk shift in the "Great Risk Shift", he makes some public policy proposals that deserve at least debate if not adoption.
Much of the book is a critique of what he calls "The Personal Responsibility Crusade", which he views as the vehicle for the shift. He tends to overreach at times. Much of the talk I have heard regarding "personal responsibility" was directed about teenage pregnancy or fathers who abandon those they impregnate and/or their children. He is right that "personal responsibility" is sometimes invoked as an argument against certain government social programs but those programs also have very real budgetary concerns that feed most of the efforts to constrain them.
Some of his arguments also seem peculiar. On page 66 Hacker quotes some corporate statements to outline what he calls the "new contract" for workers. "The only job security is a successful business" and "if loyalty means that this company will ignore poor performance, the loyalty is off the table". It is strange he would cite these as somehow new, when were they not true? Even under the "old contract", an unsuccessful business could not offer job security, nor was poor performance ignored.
Hacker makes a compelling case that there is more volatility in incomes (although incomes are generally higher) than in the past. His argument that this was essentially by design is a little less compelling. The three decades after World War II is his (and that of many others) reference point for security. That era can't be recreated. Fortunately, he doesn't resort to the easy (but unwise) option of endorsing trade protectionism, rather he recognizes the globalized economy is a fact of life and suggests a series of measures to mitigate the greater risk born by workers.
For health care coverage, he proposes something called "Medicare Plus", which is a variation on "pay or play" coverage proposals, which require employers to cover their employees or pay into the government plan that covered their employees and everyone outside of the employer market. It isn't really clear why this proposal is better than a universal government run system, other than Hacker seems to think the latter can't be enacted.
He also wants to enhance unemployment insurance and introduce "wage insurance" (for those who are displaced and take a new job that pays less than their previous job).
He also makes a proposal that appears to be novel, what he calls "universal insurance" that would cover families from an array of potential vicissitudes. Both this idea and wage insurance do not have a track record (at least not in the United States) and may not work as well in practice as they might in theory, but they at least deserve discussion.
Strong on describing the issue; Weak on solutions.......2006-11-20
"The Great Risk Shift" has much to recommend it. Hacker cogently explains the way risk has been transferred since the New Deal and Great Society eras (when health care, pensions and the like were seen as collective or corporate responsibility) to individuals. Hacker is at his best in describing the issue -- indemnity medical plans replaced with HMOs or medical savings accounts; defined benefit pension plans replaced with defined contribution plans or 401(k)s; secure, full-time jobs replaced with several part-time jobs cobbled together to make a less-than-full-time salary; broken families who cannot be relied upon for support.
Where the book falters, however, is in its view that every risk should be socialized, at least to some extent. When it comes to catastrophic health risks, many would agree that society should assist. I tend to agree with Hacker that one's medical insurance should not depend on one's employer: some businesses cannot afford adequate insurance for their employees. Likewise, adequate health insurance cannot always be purchased in the market: insurance companies "cherry pick" the healthiest candidates. Thus, Hacker has convinced me that we need some sort of baseline national health insurance, at least for significant or catastrophic illnesses (after all, we have something like it today, as those with health insurance subsidize the emergency room visits of those without it). However, we need to beware of a system with Canada-style rigidity or one which leaves no room for innovations.
Fewer would want to subsidize pensions, however, and Hacker fails to provide a real solution. The problem with defined contribution plans is not that they cannot work, but that they must be adequately funded. They can work if employers contribute enough to them so that employees can have a real pension when they retire. Likewise, individuals should be allowed to put greater amounts of pre-tax income into 401(k)s, and companies should be able to match a greater amount dollar-for-dollar. (This is the type of free-market solution that Hacker does not favor, as he believes individuals are not always able to manage their own 401(k) money.) In any event, Hacker provides no advice for those who find themselves in a defined contribution plan, under the present rules, other than "save more and stop spending on luxuries." As for broken families, that is a trend that predates "the risk shift" and will not be solved by the government. Although Hacker wants more risks to be socialized, it is important to ask what this will cost, and whether we will have a Eurpoean-style economy at the end of it.
Hacker has correctly identified the trend to shift risk from government and corporations to individuals. The question is whether the solutions he suggests will be appropriate and cost-effective. The jury is still out.
Unchallenged Assumptions.......2006-11-16
From his comfortable tenure at Yale, Jacob Hacker offers us an analysis of where things have gone wrong with the American economic system. He identifies three traditional pillars of economic security:
1. The family
2. The workplace
3. Public and private benefits
The first two are under siege. The third one is at risk. Hacker argues that the erosion of that third one - public and private benefits - is not inevitable.
Fair enough. But let's start with the family. The decrease in the stability of the family unit over the years didn't just happen. Victims of the Jerry Springerization of the family - as a mainstream example of how far things have gone askew - have no one to blame but themselves. The freedom to treat family relationships as a disposable commodity is bound to come with some trade-offs. Economic security is one of them. While the erosion of family bonds has been widespread, it is not inevitable either.
As for the other two pillars, they revolve around the ability of commerce to fund them. More corporate profits means more tax revenues - and at least the possibility of more jobs. Without corporate profits, we have no corporations to bash, no corporate profits to tax, and no jobs or benefits, public or private.
Yes, traditional jobs are under siege and traditional benefit programs are morphing. Hacker says we have choices. Yes, we do.
We could, as a society, opt to have more stable jobs, even in an era of increasingly worldwide competition. This is a valid choice. Many parts of Europe have opted for lower overall standards of living in exchange for greater job security and more leisure. Many EU citizens appear willing to tolerate double-digit long-term unemployment rates and higher tax rates in exchange for generous social safety nets.
Of course, we in America have always been looking for the free lunch. Look at U.S. savings rates, which are negative. A critical examination across all socioeconomic classes suggests that the personal saving deficit may have more to do with an insatiable appetite for big-screen televisions, $90 a month cable services, frequent restaurant dining, coiffed hair and acrylic nails, rather than for prudent expenditures on basics like food and shelter.
But by all means, we should welcome Mr. Hacker's debate. It will be useful to make explicit the trade-offs that come to light in the process.
Book Description
Using the examples of Vioxx, Celebrex, cholesterol-lowering statin drugs, and anti-depressants,
Overdo$ed America shows that at the heart of the current crisis in American medicine lies the commercialization of medical knowledge itself.
Drawing on his background in statistics, epidemiology, and health policy,
John Abramson, M.D., an award-winning family doctor on the clinical faculty at Harvard Medical School, reveals the ways in which the drug companies have misrepresented statistical evidence, misled doctors, and compromised our health. The good news is that the best scientific evidence shows that reclaiming responsibility for your own health is often far more effective than taking the latest blockbuster drug.
You -- and your doctor -- will be stunned by this unflinching exposé of American medicine.
Customer Reviews:
Overdosed America.......2007-09-03
Abramson does a well researched job of explaining why Americans take so many pills, why many of them are not necessary, and how generics are generally as effective as brand names. It is an eyeopener concerning drug research and sales practices. Very useful in most peoples' everyday life.
Exposes the REAL Drug Pushers.......2007-08-12
The author demonstrates how the drug companies have learned how to manipulate the system that approves and recommends their product. As a result, your doctor has no clue that there is very weak scientific support behind many of the expensive drugs that they are telling you to take.
The power of this book can be demonstrated by its ability to predict future events. For example, shortly after I finished reading it, a study was published in the New England Journal of Medicine regarding the popular and expensive blood sugar controlling drug Avandia. Yes, Avandia does control blood sugar, but it also increases the risk of heart attacks by 43%. Whoops!
After reading this book I now understand why the Democrats and Republicans were climbing on top of each other to be the first to pass a drug bill that no one really wanted (except the drug companies). And I know that our health care system is overly expensive and not the best.
This is one of several excellent books that explores this fascinating topic. Cholesterol Myths and Cholesterol Conspiracy are some others that come to mind. But this book is broader in scope, and gives tremendous perspective on the health care system as a whole. It is also quite empowering, because you will learn that it's good to be skeptical of doctors, whether they are pushing expensive treatments and drugs, or simply dishing out hackneyed "lifestyle" advice about changing your diet.
The bottom line is to keep fit and flexible, and you will be doing more for yourself healthwise than all the prescription pads in the world.
Patients BEWARE your doctor might be harming you with bad drugs.......2007-08-04
Thanks Dr. Abramson for being honest enough to write your book and alert the rest of us about how the drug companies have turned our physicians into legalized drug pushers. I had a feeling that this was going on for the past 10 to 15 years when drug ads began appearing on TV, drug reps began swarming around my doctor's office and my own doctor seemed to be recommending too many drugs for my ailments. This book not only made me aware but it angered me to know that there are many patients out there who are literally suffering from the serious side effects of drugs that were recommended by doctors who allowed themselves to be brainwashed by the drug companies. SHAME ON ALL OF THEM for harming us. From now on, I will never trust my doctor completely and I encourage others to do the same. Demand that your doctor recommend natural alternatives and make sure you know ALL of the side effects of a drug before taking it.
classics .......2007-08-02
Overdosed America is a classic amongst books that expose problem of America's pharmaceutical industry. This book helps expose the terrible Vioxx and Celebrex scandal whereby side effects of these drugs were known by the pharmceutical industries and to certain extent by the FDA for years before action was taken to either take the drug off the market or blacklabeled was applied. It detailed how the structure of the pharmacuetical industry (lobbist, relation to medical schools, relation to FDA, relation to doctors) lead to disincentive to reduce cost and improve healthcare industry. This book has sprawn a whole literature related to this topic. If you want to read a book related to this field, start with this one. Other books might be written by industry specialists or reporters (this author was retired family doctor), but reading this book first helps you understand what the newer books are responding to.
When will it all stop?.......2007-06-22
This book has given me reason to believe America is on a downhill spiral. No not because of our lack of Church attendance, or prayer in our schools, or even crime in our streets. No otherwise legitimate businesses are fleecing the American taxpayer, and their partner in crime is the Congress, the Senate, and the President. This to me is a very sad state of affairs. We are allowing people to die just to keep Big Pharma fat.
Revealed here are the reasons for so many of our so called incurables. Diseases for which Medical Science has no solution. At the same time Big Pharma is using it's influences to prevent scientific advances from being achieved, or at best keeping them quiet, simply because it will hurt their bottom line.
Everyone gather around, Big Pharma, is in business to make a "PROFIT," and to keep it's share holders happy. Not I repeat, not to make you well. Again at best these drugs they produce are crutches, nearly permanent crutches. My Grandfather used insulin for nearly 35 years, up until the day of his death, and we are now finding that processed foods are the biggest reason for Diabetes. You know Factory food, instead of Farm fresh food. Even sader the drug industry has the FDA on it's side to help them to continue their ruse, over our medical schools, and our doctors, not to mention the general public. Just watch some of the commercials Big Pharma uses to convince you 'restless leg syndrom' calls for pills, and not exercise. See how Big Pharma seems to have a pill for whatever ailes you. Instead of changing your lifestyle, we have a pill for that. Got a headache, there is a pill. Indigeation, here is another pill. Oh and by the way, one of the side effects of the headache pill, is it will rot your stomache. Do not worry though, we have a pill for that as well. The nausea from the ulcer pill, we have a pill for that as well. Too fat, there is a pill, etc, etc. WHAT A JOKE.
Like most things now days, we as Americans, ask very few questions, and we believe the Government is taking care of us. Believe it or not this is why our knuckle headed president is proposing limits on who you can sue in a court of law, and what your settlement will be. So what if someone died, it controls the population, and our bottom line remains intact.
Todays medications are no better than the Snake Oil, that was sold in the times before the FDA, and we have made little, if any progress.
Please read the book, ask questions, and ask more questions. Become more proactive concerning yours and your family's health.
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Life and Health Insurance Law , Loma Edition
Muriel L Crawford
Manufacturer: McGraw-Hill/Irwin
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Life and Health Insurance (13th Edition)
ASIN: 0256166994 |
Book Description
This text presents the major principles of life and health insurance law in a manner that will allow students without legal training to readily understand them. The purpose of this text is to educate students to recognize legal problems so that they can seek advice from legal counsel. The LOMA edition will be the only version of Crawford that we offer. If universities are interested in using this version, we will need to work with the Custom Publishing Department to have the cover of the text altered. The textual information can be utilized as it is. New material concerns court oversight of lawyers, market conduct, the new NAIC Life Insurance Illustrations Model Regulation, genetic information, the constitutionality of punitive damages, state statutes limiting punitive damages, the Federal Health Insurance Portability and Accountability Act of 1996, minimum premium plans, self-funded plans, stop-loss contracts, managed care organizations, utilization review, case management, health care fraud, the NAIC Model Variable Contract Law, qualified assignments of liability, Internet advertising, race discrimination, and age discrimination. Discussions of laws that have been repealed, reversed, or overruled, have, of course, been deleted from this edition.
Customer Reviews:
Easy Reading.......2001-07-08
This book is the third level (not including ACS) in obtaining your FLMI designation. Of the LOMA books I have studied, this has been the easiest reading. The case studies in the book were easy to understand. This book is well written and very interesting. If studied/read all the way through, you will receive a vast knowledge of insurance and how federal/state laws play a part in the insurance world.
Book Description
With over 100 pages of new and updated information, this edition provides a comprehensive view of the economic forces that shape change in today's healthcare delivery system. In addition to updated information throughout the text, this latest edition includes several new chapters that discuss the Internet's effect on healthcare, behavioral differences between non-profit and investor-owned hospitals, how to design a Medicare prescription benefit, and the availability of cheaper drugs overseas.
Benefits:
Students need not have a background in economics to understand this text
Discussion questions are included at the end of each chapter
Paul Feldstein is a widely recognized expert on health policy and economics
Customer Reviews:
Great book with plenty of thought provoking information........2007-09-20
This is the an excellent book to provides the reader with a great overview relevant issues in HealthCare. The format is extremely user-friendly, and the content is superior. This book was required for my Health Policy class, and it will be a keeper. Regardless of your opinions on the status of healthcare in this country, you can find useful information to defend any perspective, as well as information that will be eye-opening, possibly changing your perspective on certain issues. I thought I knew it all until I read this book. It's one of the best I've ever read. By the way, did I say how READABLE it is. As a busy physician, I hardly have time to read anything; but this was well-worth it!
thumbs up on economic explanation.......2005-09-30
This text makes the controversies regarding the state of health care systems clear. The explanations on Medicaid and Medicare make sense. The history of Canada's national health care, pitfalls, advantages, etc. give one a place to start when designing a new system of our own. Alyce Huntsinger RN NNP
Book Description
This highly successful textbook is now available in its third edition. Over the years it has become the standard textbook in the field world-wide. It mirrors the huge expansion of the field of economic evaluation in health care, since the last edition was published in 1997. This new edition builds on the strengths of previous editions, being clearly written in a style accessible to a wide readership. Key methodological principles are outlined using a critical appraisal checklist that can be applied to any published study. The methodological features of the basic forms of analysis are then explained in more detail with special emphasis of the latest views on productivity costs, the characterisation of uncertainty and the concept of net benefit. The book has been greatly revised and expanded especially concerning analysing patient-level data and decision-analytic modelling. There is discussion of new methodological approaches, including cost effectiveness acceptability curves, net benefit regression, probalistic sensitivity analysis and value of information analysis. There is an expanded chapter on the use of economic evaluation, including discussion of the use of cost-effectiveness thresholds, equity considerations and the transferability of economic data. This new edition is required reading for anyone commissioning, undertaking or using economic evaluations in health care, and will be popular with health service professionals, health economists, pharmacand health care decision makers. It is especially relevant for those taking pharmacoeconomics courses.
Customer Reviews:
Excellence for health economist.......2005-10-12
This book is excellent for health economists to initiate modern research design that use intermediate measurement to infer to longitudinal outcome. Anyway, it does not neglect the traditional methodology of health economics. Because of complicated methodology that is difficult to understand, there are not so enough the varied example to assist.
Book Description
The American health care system is in crisis. Skyrocketing costs and increasing bureaucracy have traumatized consumers and doctors alike. In The Cure, Dr. David Gratzer brings a dose of common sense to this over-regulated area of the American economy.
Customer Reviews:
The perfect antidote to Moore's Sicko propaganda.......2007-09-17
Let me state now that NO ONE is denying that healthcare in the United States is messed up right now, and is facing some SERIOUS issues. Even the most conservative Republican knows this full well and good. This is not even the issue. The real issue should be: would socializing things make our problems better or worse?
Michael Moore, in Sicko, touts Canada's socialized healthcare system, even calling it "free." (It's not free. The government also does not "pay" for it because the government does NOT have any money. Taxpayers pay for it.) Moore is of course conveniently ignoring many well-known facts. The author of Cure was a Doctor in Canada, and saw first-hand the problem with socialized medicine. His book demonstrates that it's not all that it's cracked up to be. Sorry Hillary.
In England and Canada, if you go to the doctor or the hospital, you won't get a bill. Yeah that's great. But the problem that has emerged is that it takes SO LONG to even get in for certain types of treatment that people are DYING OF EASILY TREATABLE ILLNESSES THERE. In England this has gotten SO BAD that more people are dying a year of treatable cancer than from automobile accidents!!! Yes, that's right. The cancer WAS treatable, but by the time they actually get in for treatment, it has advanced to the stage that it no longer is treatable, and the patient dies.
So, if the healthcare in Canada is SO WONDERFUL, then why are so many Canadians flooding our Northern hospitals every year? They come across the border for an appointment they can get right away, when in their own country they would have to wait nine months to a year for treatment. As shown on 20/20, dogs and cats that need surgery in Canada get it faster than humans!
By the way, if you get strep throat and have to wait a month to even get in to see a general practitioner (which is about the typical wait for GPs in Canada), then what's even the point? You'll be better by the time you get in! So, depending on whether what you have is life-threatening or not, YOU'LL MAY EITHER BE BETTER OR UNCURABLE BY THE TIME YOU EVEN SEE A DOCTOR! Who cares if it's "free"? As the Canadian woman on the September 14th episode of 20/20 said who had to come to America for a life-saving surgery that the Canadian system classified as "elective surgery" (whereas the American doctor gave her only a couple weeks to live), "Who cares if they make a profit (in America), I'm alive!"
The wait to see dentists in England is so bad that people are now performing home dentistry. We're not talking teeth cleaning here, but people pulling their own teeth out instead of having professional work done! Lines to get into the dentist in England look like the lines did at the local theater on the opening night of Star Wars Episode III. No thank you!
By the way, if the government-run medical system in Canada is so great, then why does a private clinic now open in Canada EVERY WEEK, on average, even though such clinics ARE ILLEGAL? Furthermore, if these private clinics are illegal in Canada (and they are), then why does the Canadian government do nothing to stop them? BECAUSE THE CANADIAN GOVERNMENT KNOWS IT NEEDS THEM, THAT ITS HEALTHCARE SYSTEM IS CRUMBLING, THAT'S WHY. The prime minister of Canada recently suggested that their socialized healthcare system is on the brink of collapse, and Americans are scurrying to emulate it!
This book is a much-needed reality check after the overlong season of uncritical love surrounding Moore's obscurantist propaganda documentary. In fact, it's too bad this book isn't a documentary itself; it could then act as a more effective counterweight.
Evidence versus anecdotes.......2007-08-09
David Gratzer, being a licensed physician in Canada and the US, is a credible critic of proponents of socialized medicine. He does an excellent job of providing data to support his points, and most of his points are that people supporting the concept of a single payer for health care use anecdotes rather than convincing data to show how the US health system is failing. He uses hard endpoint data, such as diagnosis of breast cancer in early stages, cancer survival data, and survival after heart attacks, to show that health care in the US leads other countries in the world and espcially those with single payer systems run by the government. He makes the point that being "politically correct" doesn't necessarily make one "scientifically correct". The way he criticizes the mind-set of socialized medicine reminded me of the methods used by Thomas Sowell in his 1995 book, "The Vision of the Anointed". He pointed out that most of the "policially correct" set ignore factual evidence. Gratzer finds these arguments and provides the evidence that is often ignored. This should be a must read for those in positions to influence the debate.
Who's Really 'Sicko'.......2007-06-28
In Canada, dogs can get a hip replacement in under a week. Humans can wait two to three years.
By DAVID GRATZER
Wall Street Journal Online, June 28, 2007; Page A13
'I haven't seen 'Sicko,'" says Avril Allen about the new Michael Moore documentary, which advocates socialized medicine for the United States. The film, which has been widely viewed on the Internet, and which will officially open in the U.S. and Canada on Friday, has been getting rave reviews. But Ms. Allen, a lawyer, has no plans to watch it. She's just too busy preparing to file suit against Ontario's provincial government about its health-care system next month.
Her client, Lindsay McCreith, would have had to wait for four months just to get an MRI, and then months more to see a neurologist for his malignant brain tumor. Instead, frustrated and ill, the retired auto-body shop owner traveled to Buffalo, N.Y., for a lifesaving surgery. Now he's suing for the right to opt out of Canada's government-run health care, which he considers dangerous.
Ms. Allen figures the lawsuit has a fighting chance: In 2005, the Supreme Court of Canada ruled that "access to wait lists is not access to health care," striking down key Quebec laws that prohibited private medicine and private health insurance.
...
Other European countries follow this same path. In Sweden, after the latest privatizations, the government will contract out some 80% of Stockholm's primary care and 40% of total health services, including Stockholm's largest hospital. Beginning before the election of the new conservative chancellor, Germany enhanced insurance competition and turned state enterprises over to the private sector (including the majority of public hospitals). Even in Slovakia, a former Marxist country, privatizations are actively debated.
Under the weight of demographic shifts and strained by the limits of command-and-control economics, government-run health systems have turned out to be less than utopian. The stories are the same: dirty hospitals, poor standards and difficulty accessing modern drugs and tests.
Admittedly, the recent market reforms are gradual and controversial. But facts are facts, the reforms are real, and they represent a major trend in health care. What does Mr. Moore's documentary say about that? Nothing.
Dr. Gratzer, a practicing physician licensed in Canada and the U.S. and a senior fellow at the Manhattan Institute, is the author of "The Cure: How Capitalism Can Save American Health Care" (Encounter, 2006).
Well informed view from the trenches.......2006-12-01
I'm surprised to be the first to review The Cure, but it's a good enough book to have a review even if it has to be mine. I read this last week, along with Crisis of Abundance: Rethinking How We Pay for Health Care, by Arnold Kling. I enjoyed them both equally, would recommend both as suitable introductions to understanding the problems of our current health care system and frequently-proposed alternatives.
The strong point of this book is that the author is licensed in both the U.S. and Canadian health care systems, and very familiar with both. Proponents of alternatives to our current system often seem to overlook the fact that all existing alternative systems also have problems, which cannot be improved by mere ignorance.
Combining this book's real world experience with the Kling book's hard-headed focus on economics provides much to chew over in the debates surely about to begin again in the U.S.
Average customer rating:
- Too many cooks (even if they are good ones) spoil the broth
- That's a good textbook for cost-effectiveness research in m
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Cost-Effectiveness in Health and Medicine
Manufacturer: Oxford University Press, USA
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Methods for the Economic Evaluation of Health Care Programmes
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Valuing Health Care: Costs, Benefits, and Effectiveness of Pharmaceuticals and Other Medical Technologies
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Designing and Conducting Cost-Effectiveness Analyses in Medicine and Health Care (Jossey-Bass Health Care Series)
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Meta-Analysis, Decision Analysis, and Cost-Effectiveness Analysis: Methods for Quantitative Synthesis in Medicine
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Prevention Effectiveness: A Guide to Decision Analysis and Economic Evaluation
ASIN: 0195108248 |
Book Description
A unique, in-depth discussion of the uses and conduct of cost-effectiveness analyses (CEAs) as decision-making aids in the health and medical fields, this volume is the product of over two years of comprehensive research and deliberation by a multi-disciplinary panel of economists, ethicists, psychometricians, and clinicians. Exploring cost-effectiveness in the context of societal decision-making for resource allocation purposes, this volume proposes that analysts include a "reference-case" analysis in all CEAs designed to inform resource allocation and puts forth the most explicit set of guidelines (together with their rationale) ever defined on the conduct of CEAs. Important theoretical and practical issues encountered in measuring costs and effectiveness, evaluating outcomes, discounting, and dealing with uncertainty are examined in separate chapters. Additional chapters on framing and reporting of CEAs elucidate the purpose of the analysis and the effective communication of its findings. Cost-Effectiveness in Health and Medicine differs from the available literature in several key aspects. Most importantly, it represents a consensus on standard methods--a feature integral to a CEA, whose principal goal is to permit comparisons of the costs and health outcomes of alternative ways of improving health. The detailed level at which the discussion is offered is another major distinction of this book, since guidelines in journal literature and in CEA-related books tend to be rather general--to the extent that the analyst is left with little guidance on specific matters. The focused overview of the theoretical background underlying areas of controversy and of methodological alternatives, and, finally, the accessible writing style make this volume a top choice on the reading lists of analysts in medicine and public health who wish to improve practice and comparability of CEAs. The book will also appeal to decision-makers in government, managed care, and industry who wish to consider the uses and limitations of CEAs.
Customer Reviews:
Too many cooks (even if they are good ones) spoil the broth.......2006-02-24
This book pulls together a lot of information, but in my opinion it is written and organized very very poorly. I have over 10 yrs of experience in in the healthcare industry and came across this book during a grad level course in CEA.
Long, boring, convoluted sentences fill the pages of this book. It took about 3 times more time and effort to get through a page in this book compared to a page in respected journals like JAMA, NEJM, BMJ etc.
If you have lots of time and are doing research in this field - go for it. Alternatively if you want to quickly determine what CEA is about, I would recommend reading Peter Muennig and Kamran Khan "Designing and Conducting Cost-Effectiveness Analyses in Medicine and Health Care".
That's a good textbook for cost-effectiveness research in m.......2000-09-20
Recently, there is less book to approach the cost-effectiveness point in medicine . I think this book can give us the new concepts of this research.
Average customer rating:
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Handbook of Health Economics : Volumes 1A & 1B (Handbook of Health Economics)
Manufacturer: North Holland
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Pricing the Priceless: A Health Care Conundrum (Walras-Pareto Lectures)
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Health Economics (3rd Edition)
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Uncertain Times: Kenneth Arrow and the Changing Economics of Health Care
ASIN: 0444822909 |
Book Description
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- History: Fiction or Science? (Chronology, No. 1)
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