Strong Medicine: What's Wrong with America's Health Care System and How We Can Fix It

Halvorson, George

Published by Random House, 1993
ISBN 10: 0679429808 / ISBN 13: 9780679429807
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Synopsis: Americans spend $900 billion a year on health care. That's more than enough dollars to ensure high-quality care for every citizen. Why aren't we getting it? And what can we do about it?

In this plainspoken book, George Halvorson cuts to the heart of our health system's failure: the incentives we offer doctors, hospitals, and insurers.

We pay for procedures, not outcomes; we reward providers for what they do -- whether it is effective or not -- instead of for improving patient health.

The result is the most wasteful, complex, redundant health care system in the world, where as much as 25 percent of all procedures performed are unnecessary.George Halvorson argues convincingly that if we want to change our system we don't need more government regulation, greater expenditure, or health care rationing. Instead, we need the right incentives. If we reward quality and efficiency, the health care system in this country will turn itself around to provide them.

George Halvorson has spent twenty-five years on the front lines of health care. He has been president of an insurance company and a senior officer at Blue Cross & Blue Shield. Today, he manages one of the country's largest and most successful managed care organizations.

This lively, readable book combines the truths and eye-opening examples he has gathered on the job with the best research and thinking on health care today. It offers proposals for reform that are readily achievable and that will ensure better-quality. care for all Americans.

From the Back Cover: "George Halvorson runs one of America's best health care organizations. He is one of the few people qualified to diagnose adn prescribe for our health system's ills. He writes with extraordinary insight and clarity. Anyone seriously concerned with health policy must read this book."

-- Dr. Alain Enthoven, Marriner S. Eccles Professor of Public and Private Management, Stanford University

From Strong Medicine

I asked a doctor who had spent years in private fee-for-service practice and then joined a large medical group where he was entirely salaried (and therefore was no longer paid based on the volume of procedures or units of care he delivered) what he saw as the major difference between the two practice modes.

"I don't have to troll for warts anymore," he said.

"Troll for warts? What's that?"

"That's what my group called maximizing revenue from patients. In order to bring our billings and profits up, we looked at each patient to see what else we could do for them. If we saw a wart, we'd say -- 'Just to be on the safe side, let's take that wart off.' The patients liked the attention, and the clinic partners liked the revenue.

"I found it demeaning. I'm glad that I don't have to do it anymore." It doesn't take an economic genius to see why "trolling for warts" makes basic economic sense in the context of fee-for-service reimbursement. The truth is that we don't pay our fee-for-service doctors to provide patients with overall improved health. We pay them to do specific medical procedures.

"In Strong Medicine the author shares his real-life learning curve about what works in reforming the health care system. George Halvorson's ideas work. His health plan has 600,000 members in one of this country's most competitive markets."

-- Dave Durenberger, United States senator from Minnesota

"Finally, here is a book that clearly communicates, in explanation example, the deficiencies in the current health care delivery system. should be required reading as it clearly defines the multiple problems and presents workable solutions. Even with my long history of involvement health care from the employer's side, were many things that I learned in reading this book."

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Title: Strong Medicine: What's Wrong with America's...
Publisher: Random House
Publication Date: 1993
Binding: Hardcover
Book Condition: Used: Good

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