Epidemic of Care

Health care premiums in the U.S. are escalating from twelve to twenty percent a year— with no end in sight. The impact of those cost increases on both employers and employees will be huge. Workers will see a direct cut in their take-home pay. Millions will lose health insurance coverage completely. Senior citizens on fixed incomes will be hit particularly hard, as premiums for their Medicare supplement plans and prescription drug costs climb. Frustrated and angry, people will soon be demanding a solution from their elected officials, and, for the first time in recent memory, the size of our unemployed population will become a real political issue rather than just the subject of energetic rhetoric. It is time to recognize that we are moving into a major health care crisis in this country, a crisis driven by the way we deliver, receive, and pay for care.
Epidemic of Care offers a comprehensive assessment of the factors behind the cost crisis, how the crisis will escalate, and what can be done to improve the situation. A blueprint for getting to a coherent national health policy, this book calls for a collaboration between different parts of the private sector, state and local governments, and, at times, the federal government— with a formula that can succeed no matter who rules Congress. Authors George C. Halvorson and George J. Isham, M.D.— two individuals who have made an impressive impact on the national health care scene— provide some practical, field-tested, sometimes controversial suggestions about how to make health care in this country more accountable, more efficient, more valuable, and more affordable. Preface and Acknowledgments.

Foreword.

Introduction: What Happened to My Paycheck?

The Authors.

1. Miracles Cost Money.

2. Unsafe at Any Cost.

3. Who Really Pays for All of That Care?

4. If It Works or Might Work, You Owe It to Me: How Americans’ Entitlement to Care Drives Up Costs.

5. Care Monopolies.

6. Does the United States Pay Fair Prices by World Standards?

7. How the Internet Is Changing Health Care: I Learned About My Prosthesis on the Web.

8. The Coming Crunch in Health Care Workers.

9. Medical Necessity Calls, Fee Cuts, and PR Errors—Not a Good Start.

10. So Why Don’t We Just Go to a Single-Payer System and Save Bucks Like the Brits?

11. Where Do We Go from Here? A Call for a National Health Strategy.

12. Patients Deserve Safe Care.

13. 401(k) Equivalent Choices in Health Care.

14. Most Health Care Costs Are the Result of Bad Health.

15. Caregiver Monopolies Should Not Be Our Care Model of Choice.

16. Cut the Number of Uninsured in Half.

17. Training Tomorrow’s Caregivers and Reengineering Care Delivery.

18. A Call to Action.

Notes.

Index.

“ This well-written book describes…in great depth the many problems that health care in the United States encounter…” (International Journal of Integrated Care, 2 August 2004)

"...one of the more lucid explanations of what is going on in US health care...the authors are well qualified to do the explaining..." (British Medical Journal, 12 July 2003)

"There is much to like about this book. Everyone can have a role in Halvorson and Isham's plan." (New England Journal of Medicine, August 28, 2003)

"The authors don't miss a trick; they have covered all the bases." (Inquiry, Fall 2003)

"...the writing style is very accessible, and the discussion includes points that may not be as commonly discussed outside of medical schools." (E-Streams, December 2003)

George C. Halvorson is chairman and CEO of Kaiser Permanente, America's leading integrated health care organization. He was formerly president and CEO of HealthPartners in Minneapolis, Minnesota and has helped start HMOs in countries around the world. Halvorson has written several books on health care topics, including the highly-praised Strong Medicine (1993).

George J. Isham, M.D., is medical director and chief health officer for HealthPartners. He is a founding board member of the Institute for Clinical Systems Improvement in Minnesota and has been a national leader in quality improvement methods.

A CURE FOR OUR AILING HEALTH CARE SYSTEM

Health care costs in America are skyrocketing, with premium increases of 30 to 40 percent not unheard of for some insurers and some consumers. And what does the system have to show for it? More than forty million uninsured citizens, inconsistent and unaccountable care, and the fastest growing and most wasteful health care delivery economy in the world. In Epidemic of Care, two of the country's most prominent leaders in health care offer a primer on health care cost drivers—and what can be done to curtail them and save the system. This hard-hitting look at a failing system reveals

• Why the cost of health care will cause deep cuts in the take-home pay of American workers—a 12 percent premium increase wipes out a 4 percent salary increase
• How voter demands for changes in the system will bring about a political nightmare
• Why many smaller companies will drop health care coverage altogether, leaving millions uninsured
• How our health care delivery system is really a non-system—with millions of independent, uncoordinated, and separately moving parts and its own priorities
• Why health care will never approach perfection until computers become exam room tools for the frontline physician
• How to cure the system in a way politically acceptable to all sides

"Everyone with a serious interest in American health care must read this book. As we seek to move the national dialogue to a higher level, this book will be the invaluable guide."
—Excerpted from the Foreword by Alain Enthoven, Marriner S. Eccles Professor of Public and Private Management (Emeritus), Graduate School of Business, Stanford University