Monday, April 16, 2012

Voices of Health Reform: Interviews with Health Care Stakeholders: Options for Repackaging American Health Care, 209 pages, by Richard L. Reece, MD, Practice Support Resources (2005), 209 pages, $51 on Amazon or from www. or call 1-800-967-7790, to order directly from the publisher.
The deep moans around with many voices,
Come, my friends,

'Tis not too late to seek a better world.
Alfred North  Tennyson (1808-1892), Ulysses

April 17, 2012 -   I know what you’re thinking.  Why review a book on health reform that is 7 years old?
My motives are straightforward.

·        It is my book, so why not?

·        It contains 40 interviews with movers and shakers of the health reform world, something you won’t find elsewhere.

·        It traverses the views of  health care universe leaders – from conservatives to liberals, from private to public stakeholders, from idealists to liberals - most of whom are still major players.

The book is split into  6 sections with 6 -8 interviews in each section:
·        Part 1 – Leaders advocating private –public interests as the solution

·        Part 2 – Leaders advocating government –assured coverage solution.

·        Part 3 – Leaders advocating consumer-driven solution.

·        Part 4 – Leaders representing vested interests of physicians and hospitals.

·        Part 5- Leaders representing vested health plan interests.

·        Part 6- Leaders representing support and supply chain interests.
As if that were not enough, it concludes with these practical conclusions, most of which are still relevant.
1. Fragmentation and conflicts between health care interest groups renders reform intractable, but collaboration is essential if we are to preserve the best of our present system.
2. Single-payer backers, still committed, are seeing practical opportunities slip away.
3. Medicare, in its present form, is unsustainable.

4. These days the consumer-driven movement is on everybody’s mind.

5. Regional ideological and regional differences matter.

6. Hospital and physician collaboration remains an “iffy’ matter.

7.  The consumer movement means different things to different health stakeholders and opens up enormous opportunities.

8. American physicians increasingly consider themselves a disenfranchised minority.

9. Medicare and managed care organizations are placing their reform bets on the pay-for-performance movement.
10. Health care systems are difficult to manage because they composed of  independent  individuals and independent organizations acting in their own best interests at the boundaries of care.
11.  Information technologies are often seen as the Holy Grail of Health Care, but these technologies will not work if they ignore the Elephant in the Room, reluctance of small physician practices to install electronic records.
12.  Final conclusion – our health system is a creature of our culture.
Tweet:  Voices of Health Reform  is a 2005 book  which contains 40 interviews with health reform stakeholder leaders about prospects for reform.

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