So I got an email from a student asking for a basic primer on the US Healthcare system. He’s at Northwestern, so I might recommend him Edward FX Hughes as a go to guy. But my two favorite books about health care are The Social Transformation of American Medicine (by Paul Starr) and Demanding Medical Excellence (by Michael Millenson). Neither are exactly beginner material. I was originally quite taken 15 years ago with Joe Califano’s America’s Health Care Revolution, but that’s pretty dated now.
Given that I haven’t written the definitive work myself, and that Jon Cohn hasn’t finished his book yet, what would you suggest as a great introduction? (Yup, this is an open thread…). And are there millions of students just waiting to buy such a book if I write one? (Publishers wishing to send advances, please email me!!)
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//Wow, Abby’s pretty smart!
I meant to tell her that I worship the ground on which she walks for the “feature not a bug” remark. :-)//
Thanks Gadfly!
Dr. Faria also wrote:
When Hillary Clinton and Ira Magaziner assembled a health care brain trust to “reform” the existing system, they staffed it with many architects of the current system of corporate socialized medicine. As the Association of American Physicians and Surgeons (AAPS) discovered in a landmark lawsuit filed against the Clinton Administration (AAPS v. Clinton), the secretive health care task force was staffed with representatives from corporate managed care entities such as the Henry Kaiser Permanente and Robert Wood Johnson Foundations.
Liberals just love the large insurance companies.
Ooops — forgot one important one on my list…
Robert Cunningham x2, The Blues: A History of the Blue Cross and Blue Shield System.
Johnathan Cohn,
Dr. Goodman, President Bush’s advisor, really burned me up when Al Gore said the Bush’s propasal of a $3,000 tax credit for the poor was not enough to purchase health insurance because family insurance costs $6,000 a year (2000). Goodman replied that, “Family insurance costs $4,000 a year.” I could of died. MSA isnurance was only $80 a month for a 30 year old couple and two children in Des Moines, Iowa. i thought, darn, with friends like this we need no opponents.
Then my wife met Dr. Goodman and asked him, “Why hasn’t the first senior got their very first tax free deposit in an Medicare MSA even though it was passed by both Houses of Congress and signed by President Clinton in the 1997’s Balanced Budget Agreement (BBA). He said he didn’t have a clue.
Consumer Driven Health Care (CDHC) is just a term that smhucks use to confuse people on the tax free HSA. Real people, in the know, never say “CDHC” but instead say, “Tax Free HSA,” like President Bush.
If Dr. Goodman enrolled at least one client in a tax free HSA he would be smarter.
It’s very flattering to be mentioned in such distinguished company. (I’m working as fast as I can.)
Meantime, I’d second the recommendation of Paul Starr’s book and add these:
– Rosemary Stevens, In Sickness and in Wealth. (Does for the hospital system what Social Transformation does for the medical system.)
– Charles Rosenberg, The Care of Strangers. (For the early history of hospitals, i.e., the period before Stevens’ book.)
– The Politics of Medicare, Theodore Marmor. (Definitive account of Medicare from creation to the present)
– Health Against Wealth, George Anders. (A solid, well-written tour of the world of managed care circa 1995.)
– Jacob Hacker, The Divided Welfare State. (Excellent history of the U.S. private health insurance system, alongside retirement security.)
Now, most of those authors have a liberal viewpoint (though they disagree among themselves on certain fine points of policy and interpretation). The history is unimpeachable, but if you want a more conservative interpretation on contemporary policy questions I’d suggest the book put out by Cato during the Clinton fight: Patient Power by John Goodman. Regina Herzlinger’s work gets a lot of attention these days, as she’s become a big promoter of consumer-driven health care. She’s got two books: Market-Driven Health Care and Consumer-Driven Health Care (though you can just get a hold of one of her Harvard Business Review articles and pretty much get the gist of the message.)
And speaking of the Clinton health care battle, The System, by David Broder and Haynes Johnson, is a *very* thorough history of that episode, though if you’re more interested in broader issues of policy/philosophy as opposed to Washington process stuff, you might instead check Theda Skocpol’s Boomerang or Hacker’s Road to Nowhere.
OK, back to work on chapter four…
//is smarter than Abby.//
Wow, Abby’s pretty smart!
I meant to tell her that I worship the ground on which she walks for the “feature not a bug” remark. 🙂
Johnathan, do you understand this part:
“in the view of government regulators,”
Hillary wrote a book on her health care plan so there is no need for you to be clairvoyant. If government regulators said that you couldn’t have surgery on your daughter and you paid for surgery anyway, with your own personal funds, that would be illegal and you and your doctor could be fined and imprisoned.
Dr Faria said that when cost is the most important consideration that’s like medicine for a horse or a cow. Afterall, who would spend $5,000 to save a cow that was worth only $1,000? Who wants some government regulator approving care based on the citizens’ value to society?
People are citizens, pet’s are not.
Vote for Hillary / Be treated like a dog.
I like “Medical Care, Medical Costs” by Rashi Fein. He lays out a history of how we came to be in the fix we are in now. Rashi Fein is professor of the economics of medicine, emeritus, at the Harvard Medical School. I would call his approach balanced: the Amazon book description says “Fein argues that the quest for efficiency in the delivery of health care services must be joined with a concern for equity in their distribution and that we need policies informed by long-held values, traditions, and experiences in the shaping of medical care delivery.”
I know it’s old, but the sweeping changes taking place right now haven’t been covered by anybody that I know of.
Amazon has it for $11.00; cost is always a factor.
Ron, please explain this remark:
“…the Administration’s socialized medicine plan would not deny treatment unless ‘it is not appropriate,’ meaning that in the view of government regulators, it ‘will not enhance or save the quality of life.’ What of doctors who took their Oath of Hippocrates seriously and sought to provide treatments not covered by the federal plan?”
I take Clinton’s statement to apply to treatments that are not expected to enhance or save the quality of life or don’t have a reasonable chance of doing so, since none of us are clairvoyant. Given that, what part of the Hippocratic oath demands that you treat people even when it won’t enhance or save the quality of life?
Understanding Health Policy by Thomas Bodenheiner is excellent.
I like Dr. Miguel Faria
In Overdose of Socialism he wrote:
As explained by Hillary Clinton in testimony to the Senate Finance Committee on September 30, 1994, the Administration’s socialized medicine plan would not deny treatment unless “it is not appropriate,” meaning that in the view of government regulators, it “will not enhance or save the quality of life.” What of doctors who took their Oath of Hippocrates seriously and sought to provide treatments not covered by the federal plan? Under HillaryCare, if doctors provided “unauthorized” treatment on a fee-for-service basis, they would have been subject to fines as large as $50,000, forfeiture of their property, and — in some cases — life imprisonment. When such horrific provisions received widespread publicity, the HillaryCare scheme was defeated — apparently. It is not widely understood that the Administration’s rejected plan to socialize health care merely amplified the statist trend presently undermining our health care system. That trend is best described as “corporate socialized medicine” — or, if one prefers, medical fascism.
Under the ethics of Hippocrates, physicians place the interest of the individual patient above that of the practitioner or society at large. But under corporate socialized medicine, or what is more commonly known as “managed competition,” the physician is required to place cost considerations and the interest of third-party payers — such as insurance companies and Health Maintenance Organizations (HMOs) — above the concerns of the patient. This leads to the adoption of what Swiss physician-philosopher Ernest Truffer calls the “veterinary ethic,” in which the human patient is treated like a pet and provided with the type of medical care determined by the “master” — in this case, the person or corporation responsible for paying the medical bills.
http://www.thenewamerican.com/tna/1999/06-21-99/vo15no13_overdose.htm
Dr Faria is a brain surgeon and is smarter than Abby.