I spent nearly 30 years consulting with employers about the design and operation of the health insurance and retirement benefits they provided their workers. In my work, I was familiar with economic studies showing that workers’ wages and salaries have been increasingly skewed toward higher earners and was convinced the results were less pronounced for workers' total rewards.. In developing my analysis I came to understand that the cost of employees’ health insurance was consuming a large share of workers’ growing rewards. This led me to explore how the US health system was imposing much higher costs on workers than any other segment of society and how we might address the problem.
U.S. consumers understand our health care is expensive but do not grasp who is being victimized by these high costs and how they are imposed. The analysis developed here and documented with data shows that it is the working-age population covered by private insurance―especially those covered by employer-sponsored insurance—who are most burdened by the system's high costs.
The analysis goes on to show how various segments of the health delivery system impose higher costs on the working-age population with private insurance than on those covered by Medicare, Medicaid, and other public insurance plans. The latter part of the analysis sets out alternative ways and policies that could reduce costs over time and lighten the disproportionate load imposed on workers and their dependents.
Case and Deaton tell an extremely sobering story about the recent decline in life expectancy in the United States.
It is a story about the crumbling foundation of what has traditionally been considered a meaningful life: the comfort of belonging to an organized religion, a stable marriage and family, a successful working career and home ownership.
In their place, the new reality is often one of low wages, failed personal relationships, erratic work patterns, pain, addiction to alcohol and drugs, and incidents of ultimate despair—suicide.
The underlying causes of this social transformation include technical changes in how we do work in our economy and globalization that have left behind those with lower levels of education, declining unionization, and the operation of various aspects of the health system.
In the case of the latter, the pharmaceutical companies get special attention in relation to the opioid epidemic but more generally the high cost of healthcare is a major factor in limiting wage growth and elimination of jobs especially for those at lower earnings levels.
A New York Times Bestseller A Wall Street Journal Bestseller A New York Times Notable Book of 2020 A New York Times Book Review Editors' Choice Shortlisted for the Financial Times and McKinsey Business Book of the Year A New Statesman Book to Read
From economist Anne Case and Nobel Prize winner Angus Deaton, a groundbreaking account of how the flaws in capitalism are fatal for America's working class
Life expectancy in the United States has recently fallen for three years in a row-a reversal not seen since 1918 or in any other wealthy nation in modern times. In the…
One prevailing theory about the high cost of U.S. health care compared to other highly developed nations is that the prices charged for goods and services are simply higher in the United States and elsewhere.
Reinhardt is one of the leading proponents of this school of thought and this book summarizes his reasoning on the subject and how to deal with it.
From a giant of health care policy, an engaging and enlightening account of why American health care is so expensive-and why it doesn't have to be
Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of the U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country,…
John Wennberg is a medical doctor and researcher who has spent much of the last half century analyzing the practice of medicine across the United States.
He has used Medicare patients’ treatment records to show that health delivery is often more dependent on the supply of providers and facilities in an area than the expected demand for such treatment of the area population.
He and his associates have also shown that more intensive treatment generally does not result in better care and sometimes leads to more adverse outcomes.
Written by a groundbreaking figure of modern medical study, Tracking Medicine is an eye-opening introduction to the science of health care delivery, as well as a powerful argument for its relevance in shaping the future of our country. An indispensable resource for those involved in public health and health policy, this book uses Dr. Wennberg's pioneering research to provide a framework for understanding the health care crisis; and outlines a roadmap for real change in the future. It is also a useful tool for anyone interested in understanding and forming their own opinion on the current debate.
These medical doctors explore the introduction of new medical practices that are subsequently shown to be of no value to patients or even harmful.
Prasad and Cifu report on a variety of procedures and practices often used widely that have been proven ineffective. They review 10 years of a prominent medical journal's articles reporting the results of efficacy studies of existing and new practices.
Of 363 articles reporting on the results of studies on existing practices, 40.2 percent indicated the practice of no value or harmful to the patients and another 21.8 percent were inconclusive on whether the practice was beneficial or not.
In looking at 981 articles on studies of new practices, 16.8 percent found the practice of no benefit or harmful and another 6.1 percent were inconclusive.
In the latter sections of their discussion, they describe ways to address the prevalence of what they call “medical reversals.”
Why medicine adopts ineffective or harmful medical practices only to abandon them-sometimes too late.
Medications such as Vioxx and procedures such as vertebroplasty for back pain are among the medical "advances" that turned out to be dangerous or useless. What Dr. Vinayak K. Prasad and Dr. Adam S. Cifu call medical reversal happens when doctors start using a medication, procedure, or diagnostic tool without a robust evidence base-and then stop using it when it is found not to help, or even to harm, patients.
In Ending Medical Reversal, Drs. Prasad and Cifu narrate fascinating stories from every corner of medicine…
Dr. Puri is a specialist in palliative care for patients with terminal conditions.
She describes the challenges she has encountered during her medical training and practice in dealing with a medical establishment committed to intensive care even in the face of insurmountable odds that such care will improve patients’ health or quality of life.
She also describes encounters with patients’ families who demand intensive medical treatment and are unwilling to allow patients to transition peacefully through the end of life. Often the demand for intensive care is made without the desires of the patient being considered.
This is a poignant set of stories showing that intensive care in what is often the most expensive medical cases exact a price far higher than the dollars involved in the transaction.
"A profound exploration of what it means for all of us to live-and to die-with dignity and purpose." -People
"Visceral and lyrical." -The Atlantic
As the American born daughter of immigrants, Dr. Sunita Puri knew from a young age that the gulf between her parents' experiences and her own was impossible to bridge, save for two elements: medicine and spirituality. Between days spent waiting for her mother, an anesthesiologist, to exit the OR, and evenings spent in conversation with her parents about their faith, Puri witnessed the tension between medicine's impulse to preserve life at all costs and a spiritual…
Gabrielle found her grandfather’s diaries after her mother’s death, only to discover that he had been a Nazi. Born in Berlin in 1942, she and her mother fled the city in 1945, but Api, the one surviving male member of her family, stayed behind to work as a doctor in a city 90% destroyed.
Gabrielle retraces Api’s steps in the Berlin of the 21st century, torn between her love for the man who gave her the happiest years of her childhood and trying to come to terms with his Nazi membership, German guilt, and political responsibility.
Api's Berlin Diaries: My Quest to Understand My Grandfather's Nazi Past
"This is not a book I will forget any time soon."
Story Circle Book Reviews
Moving and provocative, Api's Berlin Diaries offers a personal perspective on the fall of Berlin 1945 and the far-reaching aftershocks of the Third Reich.
After her mother's death, Robinson was thrilled to find her beloved grandfather's war diaries-only to discover that he had been a Nazi.
The award-winning memoir shows Api, a doctor in Berlin, desperately trying to help the wounded in cellars without water or light. He himself was reduced to anxiety and despair, the daily diary his main refuge. As Robinson retraces Api's…
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