Flatlined: Resuscitating American Medicine

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Flatlined lifts the veil of secrecy on twenty-first century health care and delves into the realities of good people caught in a bad medical system. Dr. Guy L. Clifton, a practitioner as well as a policy advocate, reveals first-hand accounts of needless tragedy, such as the young man who died after a car wreck for lack of a bed in a qualified hospital and the surgeon who was dejected by the scarcity of resources needed to enable him to perform heart surgery on an uninsured man.

Arguing that a lack of coordinated care and quality medical practice benchmarks result in high levels of redundancy and ineffectiveness, Clifton proposes that the key to reducing health care costs, improving quality, and financially protecting the uninsured, is to reduce wastefulness, and offers a solution for achieving success.

Flatlined sounds the warning call: By 2018 Medicare and Medicaid will consume about one-third of the federal budget. American businesses now pay three times as much of their payroll for health care as global competitors, expected to worsen as health care grows at twice the rate of the U.S. economy. Based on his years of experience in policy and medicine, Clifton offers an attainable solution through the development of an American Medical Quality System.

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Editorial Reviews


"This well-researched volume offers well-argued suggestions, and is intentionally accessible to the general public who, the author believes, much be enlisted in the campaign for change. Clifton's model is an interesting middle road between a nationalized and a privatized system. Recommended."

Foreword Reviews

"This book testifies to the author's mastery of complex data in economics as well as medicine. A politically savvy and psychologically astute analyst, he sums up dozens of studies on the current crisis, illustrated with warm-hearted stories. His book is a major resource for those involved with healthcare reform and, for all concerned, a powerfully good read."

The Lancet

"Guy Clifton [is] a distinguished Texan neurosurgeon who spent a year as a Health Policy Fellow in the US Congress to develop the ideas he presents in this enlightening book, which I think is by far the best of its kind in recent memory. Clifton tells us that physicians need to have a financial incentive for practising efficient medicine. The new administration would do well to read this book, if it is, indeed, committed to intelligent health-care reform."

— Noah Raizmann

Publishers Weekly
Starred Review.

In this insider's polemic, neurosurgeon and clinical investigator Clifton warns that the U.S. health-care system is dying on the table, the victim of an insurance system using unnecessary, high-tech medical procedures and diagnostic tests to generate more fees, and a pharmaceutical industry pushing two-dollar prescription pills where a 24-cent Aleve would do. Clifton estimates that 30 percent of all delivered health care services (about $700 billion a year) qualify as unnecessary treatment; the results are skyrocketing costs, growing ranks of the uninsured crowding the nation's emergency rooms, and an underserved, often in-the-dark patient class. On the basis of his 30-year career as a neurosurgeon and administrator, with a two-year stint in Sen. Orin Hatch's office, Clifton advocates an independent agency, financed by congress, that would work with doctors and hospital administrators to set standards for treatment and fees, aiming for no less than a "high-performance U.S. healthcare system... providing quality care at lower cost to all its citizens." An eye-opening, sausage-maker's perspective on contemporary medicine, Clifton's thorough text deserves the attention of policy makers, health professionals, and anyone regularly shuffled (or shoved) through the maze of U.S. health care.
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

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Product Details

  • ISBN-13: 9780813544281
  • Publisher: Rutgers University Press
  • Publication date: 12/2/2008
  • Edition description: New Edition
  • Pages: 304
  • Sales rank: 366,749
  • Product dimensions: 6.20 (w) x 9.00 (h) x 1.30 (d)

Meet the Author

Guy L. Clifton, M.D. is a neurosurgeon, clinical investigator, administrator, and health policy advocate. He holds the Runnells Distinguished Chair in Neurosurgery at the University of Texas Health Science Center at Houston. He has been listed in Best Doctors in America since 1996. As a 2006û2007 Robert Wood Johnson Foundation Health Policy Fellow and Senior Health Policy Advisor at the New America Foundation, he is now devoting himself full-time to health policy reform issues in Washington.

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Table of Contents

1 Not business as usual 3

2 Unreliable emergency services 10

3 An eroding infrastructure 16

4 Fifteen years lost 25

5 Handed health care's leftovers 35

6 Where we are headed 49

7 30 percent waste - or 50? 57

8 Poor-quality primary care 67

9 Dangerous hospitals 77

10 Violation of dignity : the end of life 94

11 Unnecessary surgery 103

12 Perverse payment incentives 120

13 Three pathways to hospital profitability 139

14 Pharmaceuticals : remarkable innovation, shameless puffery 157

15 Private health insurance : no added value 170

16 Three options for covering the uninsured 179

17 No coverage expansion without cost control 201

18 A workable plan for reform 212

19 Establishing standards 224

20 Prioritizing primary care 232

21 Reducing spending on hospitals and specialists 243

22 Positioning of an American medical quality system 261

Notes 275

Index 313

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Sort by: Showing all of 2 Customer Reviews
  • Posted February 20, 2012

    great thoughts. well balanced.

    Quick read with a look from most sides of the health care issue in America.

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  • Anonymous

    Posted August 18, 2011

    No text was provided for this review.

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