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Gag Gifts, Occasion Gifts - Market-driven Health Care: Who Wins, Who Loses In The Transformation Of America's Largest Service Industry
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List Price: $19.00
Our Price: $13.87
Your Save: $ 5.13 ( 27% )
Availability: Usually ships in 10 to 13 days
Manufacturer: Basic Books
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Average Customer Rating:  
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Binding: Paperback
Dewey Decimal Number: 362.10973
EAN: 9780738201368
ISBN: 0738201367
Label: Basic Books
Manufacturer: Basic Books
Number Of Items: 1
Number Of Pages: 416
Publication Date: 1999-05-20
Publisher: Basic Books
Studio: Basic Books
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Editorial Reviews:
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What happens when the demanding consumers who nearly brought the U.S. automobile industry to its knees focus the same kinds of pressure on the industry that represents one-seventh of the U.S. economy—health care? The health organizations that combine quality, convenience, information, choices, and lower costs will be the winners in this revolution. Regina Herzlinger, chaired professor at the Harvard Business School, distills the facts from the noise surrounding the one industry whose measures of success are life and death. In a thoroughly readable, anecdotal style, she pinpoints the drivers of change—the savvy consumer, the cost-conscious payer, and the rapidly improving technology—that will revolutionize the American health-care system. This is a must-read for those in every corner of the immense health-care web. With its strong narrative style, this is a book that will be read and talked about by everyone concerned about the future of American health care.
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Spotlight customer reviews:
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Customer Rating:
Summary: Aged reading but still has relevance for the Healtcare industry
Comment: Recommended reading for any healthcare professional or related work however like any book written on a topic relating to a point in time, things change and some of that has for the subject matter in this book. Well written and informative..
Customer Rating:
Summary: OVER THE EDGE
Comment: THE IDEA THAT " THE MARKET " CAN FIX ANYTHING HAS BEEN AROUND A LONG TIME.
AND IT CAN IF YOU ARE ON THE RECEIVING END OF THE PAYMENT SYSTEM. IT'S GREAT! HOWEVER IF YOU ARE THE " PAYER " I.E. WORKING FOR LITTLE OR NOTHING, PAYING TAXES, BUYING THREE DOLLAR GAS, GETTING YOUR RATTLE TRAP CAR FIXED SO YOU CAN GO TO YOUR EIGHT DOLLAR AN HOUR JOB...YOU REALLY CAN'T FIX ANYTHING.
VOTING DOES NO GOOD WHAT-SO-EVER AS EVERY POLITICIAN WHO HAS EVER LIVED IS ON BOARD FOR ALL THE MONEY THEY CAN GET. THE ONLY THING THAT WILL WORK, REALLY WORK IS IF THE PEOPLE OF THE USA TAKE THEIR GOVERNMENT BACK AND MAKE IT WORK IN THE BEST INTERESTS OF ALL. THIS IS NOT LIKELY TO HAPPEN SOON BECAUSE 99%
OF PEOPLE IN THIS COUNTRY ARE BRAIN-WASHED DAILY INTO BELIEVING THEY HAVE NO POWER.
GET READY FOR MORE "MARKET" DRIVEN "SOLUTIONS" FOR YOUR EVER MOUNTING PROBLEMS. AND IF YOU HAVE YOUR HEAD IN THE SAND YOU DESERVE WHAT YOU GET IN THE END...
Customer Rating:
Summary: market s in healthcare?
Comment: Herzlinger is a card-carrying member of the club that believes that markets can cure all social ills, and like all members of this club, she plays fast and loose with reality. For instance, she tries to present the vision market as an exemplar of how market forces can work in healthcare. Vision is one of the few areas of medicine where patients can appraise the value of the service, the quality of the provider, and make decisions about how much they are willing to pay. That is simply not the case when a patient is really sick with heart failure, and needs multiple medications, multiple doctors, and is probably going to be hospitalized repeatedly.
In trying to argue that all aspects of medicine can follow market rules the way vision services do, Herzlinger conveniently ignores one critical fact: there is no true market in the healthcare industry, and there can't be. Kenneth J. Arrow, Nobel Prize winning economist pointed this out 30 years ago, and his observations are still true today. Providers (doctors and hospitals, and increasingly the drug and device industries) drive demand for their services. They are the ones who decide what patients need. The notion that patients can have suffient information to be able to determine what they need is probably only true for the 80 percent of people who consume 20 percent of healthcare costs. The 20 percent who eat up 80 percent of costs are sick with multiple conditions. Imagine your grandmother is in the hospital, sick with diabetes, and pneumonia, scared, having a hard time breathing, and she's supposed to sort through whether or not she should pay the $600 to call in the pulmonologist? The patients with chronic, multiple, debilitating disorders actually need the exerpertise of medical professionals.
Her focused factories have come to pass: they are called specialty, or even super-specialty, hospitals, which focus on one procedure, or one category of specialty. There are cardiac hospitals, for instance, that only perform by-pass surgery, cardiac catheterization,angioplasty, and stenting. Are they good at what they do? Sure, because they focus on a narrow range of procedures, they only take insured patients, and they don't take anybody with comorbidities. Of course, the really expensive patients tend to have comorbidies. The effect of the specialty hospitals on local healthcare markets? They do not bring down costs, they simply drain profit from full-spectrum community hospitals, which still have to care for all those patients with pneumonia and who don't have health insurance.
The imbalance of information between physician and patient is simply insurmoutable, and without that kind of balance, markets don't work very well.
Customer Rating:
Summary: So she's no Tolstoy, but the ideas are great.
Comment: No one will accuse Ms. Herzlinger of being a great writer, but her conversational style is easy to read and she does have some good ideas for how the healthcare industry should be. Ideas that still haven't been implemented even now, 8 years after it was written. She does make a fairly convincing argument for how focused factories could reduce costs. In addition, suggestions that everybody should have health insurance, that healthcare providers should not be insulated from market forces, that consumers are the ones with the real power to stop the soaring healthcare costs, and that they'll only curtail spending when given incentive to do so are good points that can't be made often enough. Points that seem even more relevant today given the continued increase in healthcare costs, the inability of the HMO system to manage them, and the spiraling problem the growing uninsured population is creating (the more uninsured people there are, the more insurance costs, which increases the number of uninsured, etc.). She has good ideas, I think it's time people listened. It's of vital importance that the healthcare system incorporate what's great about America, what has made America a leader in every other industry: innovation and sensibly regulated free markets. Ms. Herzlinger gives us a good way to get it done.I also have to ask if some of the other reviewers actually read the book. The author gives a pretty good analysis of how focused factories would reduce costs, using that 20% of the people produce 80% of the costs as a cornerstone of her argument. Also, she cites physicians' inability to deal with market forces as a cause of the problem and gives suggestions for how to deal with it.
Customer Rating:
Summary: There is no "market" in American medical care, period.
Comment: Market forces cannot solve the medical crisis. No market exists. Knowledge of what is sold is inequivalent: if patients knew the difference between colonoscopy and colposcopy, they would not know the fair market value of either procedure. Unlike buying a car, where the dealer knows you can walk off, patients cannot negotiate, and can't determine the quantity of medical services needed. Eyeglasses constitute a misleading example. Physicians are the principal drivers of all expenditure on medical care. Without a medical license, nothing can be ordered or prescribed. This fact must be faced squarely: the supplier of services regulates the level of demand for medical services. Annual outlays have now reached $1.6 trillion with no end in sight to the physician-driven escalation in expenditures. This is not COST inflation, but relentless EXPENDITURE INCREASE driven chiefly by an oversupply of medical doctors. If this system is ever to be fixed, these stubborn realities must be faced. This author evidently has no clue that there is not a "market" operating in the world of medical care delivery, thus her analysis is unhelpful.
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