Book Review: Health Care Will Not Reform Itself

Credit: Jared Rodriquez

We are vociferous readers at the Society of Actuaries and we want to pass on our review of a book that has gained renewed interest in health care circles. In his New York Times best seller, Health Care Will Not Reform Itself: A User’s Guide to Refocusing and Reforming American Health Care, Kaiser Permanente CEO George Halvorson addresses the inadequacies with the U.S. health care system and improvements that can be achieved through health care reform, which is “within our reach.”

This book came out in 2009 as Congress prepared to debate the Patient Protection and Affordable Care Act. As the ACA heads to the Supreme Court it is interesting to look back at the arguments Halvorson put forth.

Halvorson begins the book with a framework for reform that equally values improvements in care and curbing health care costs. An organized, systematic approach to care delivery and care improvement does not currently exist, according to Halvorson, and he contends that the best health care system is one that focuses on good health and care for everyone.  He points out that chronic conditions drive over 75% of the health care costs in the U.S. because the country does not do a good job of intervening and preventing diseases – almost all of which are preventable.

Following are some interesting data from the book:

  • U.S. health care costs total $2.7 trillion
  • 1% of the patients consume 30% of the dollars
  • 5% of the patients consume 50% of the dollars
  • The healthiest 50% consume only 10% of the dollars

Halvorson suggests the U.S. needs a combination of prevention and better care. He argues that while good health care is expensive, it is nowhere near as costly as bad health care. He also emphasizes the importance of connectivity, and that by getting care right in a connected way, and when doctors are connected, you can make a huge difference in the care you’re providing and save money by doing so. As such, the U.S. needs to be fully committed to IT (i.e., electronic medical records for patients and physicians) in order to deliver better care.

By limiting complications, health care will in turn, become less expensive. Before any of this can happen, the U.S. must think systematically about the desired outcomes and work backwards to determine what needs to be done operationally, logistically, functionally and financially.  Once that goal has been set, the tools that support the goal can be built.

Whether you agree with Halverson or not, you must admit he does a good job of summarizing the key issues Congress tried to address with the ACA and will revisit in 2012. Here is our question for you: If you were asked to propose the topic for what would inevitably become the top health care book in 2012, what would the subject be?

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