Fresh Medicine: How to Fix, Reform, and Build a Sustainable Health Care System

by Phil Bredesen

Overview

An authoritative, engaging, and nonpartisan look at what is wrong with American health care and how we can fix it—“told with skill and grace” (Jon Meacham, author of American Lion).

Former Governor of Tennessee and CEO of HealthAmerica Corporation, Phil Bredesen “knows the American health care system inside and out. He knows both the theory and, more importantly, how things really work.” In Fresh Medicine, he analyses the current state of American Health Care, beginning with a clear-eyed critique of the Affordable Care Act (Bill Frist, M.D., former Senate majority leader).

According to Bresden, the Obama Administration ushered million more people into a broken system while doing little to address the underlying problems. Looking back over the past century, Bresden explains how that system developed from local doctors making house calls to today’s sprawling insurance model. What began as an insurance system to cover hospitalization has expanded to cover drugs, doctor visits, and the treatment of chronic disease. American health care, Bredesen asserts, needs to be reset on a new foundation. In Fresh Medicine, he harnesses thirty years of experience to offer a new solution.

Product Details

ISBN-13:	9780802196248
Publisher:	Grove/Atlantic, Inc.
Publication date:	02/26/2020
Series:	Books That Changed the World
Sold by:	Barnes & Noble
Format:	eBook
Pages:	273
File size:	3 MB

About the Author

Philip Bredesen is the Democratic governor of Tennessee. Before being elected governor in 2002, and reelected in 2006, he was mayor of Nashville, and prior to that the founder and CEO of HealthAmerica Corporation, a public managed-care company. Bredesen graduated from Harvard in 1967 with a bachelor's degree in physics. This is his first book

Table of Contents

Introduction 1

A Contrarian View 10

What's Wrong with Reform 24

The Roots of America's Health Care System 45

Health "Insurance" 61

Moving Forward 69

Stepping-Stone 1 Dignified, Fair, and Universal 77

Stepping-Stone 2 Why Health Care is so Expensive 97

Stepping-Stone 3 Managing Hypercomplexity 121

Stepping-Stone 4 Quality 140

Stepping-Stone 5 Systems of Care 162

Stepping-Stone 6 Paying for Health Care 181

Putting it All Together 207

Twenty Years Later 225

Epilogue 245

Acknowledgments 249

Editorial Reviews

Beginning with the words "Health care in America is broken," and the claim that its underlying structure (insurance; uncoordinated providers) is obsolete, Tennessee governor Bredeson lays out a "new set of principles" to guide reform. While he supported President Obama's health care reform package, he now calls it "a stunning disappointment" and flags an inadequate funding mechanism and the act's failure to establish fiscal and quality control, which will lead to sky-rocketing costs. He proposes many improvement measures, including six well-considered "stepping stones," like the establishment of a trust account modeled on Social Security and financed by new taxes, and an independent audit of healthcare organizations, and would replace the recently-challenged mandate with a national voucher system. Prior to public service Bredesen founded and ran a managed-care company and, as governor, has been faced with overseeing TennCare, the State's controversial experimental program which, he writes, is an example of how a well-intentioned medical reform can spin "wildly out of control." Bredesen's belief in the value of direct experience led him to undertake this endeavor and he crystallizes that experience into a concise yet comprehensive effort.
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Publishers Weekly

In this important new look at a topic of urgent concern to the country, Phil Bredesen does something unique: he brings together the perspectives of a businessman, a politician, and an historian to tell the story of health care in America. Told with skill and grace, Fresh Medicine explains how we got where we are, and what we have to do going forward. Bredesen has given all of us a great gift.” —Jon Meacham, author of American Lion: Andrew Jackson in the White House

“Phil Bredesen knows the American health care system inside and out. He knows both the theory and, more importantly, how things really work. His perspective is unique and wise; if you’re interested in health reform, you’d do well to read and consider what he has to say.” —Bill Frist, M.D., former Senate majority leader

“Fresh Medicine is at once an indictment of the current state of our health care system and a pointed plan for a new model.”— The Nashville City Paper

“Few public officials in America are as experienced in health care issues as Tennessee’s governor, Phil Bredesen. He knows the subject from the standpoint of a health care management executive in the private sector and as the governor who rescued his state’s Medicaid program (and his state) from impending bankruptcy. He has distinctive views on how America’s broken health care system should be reformed. And he can express his ideas well.” —Mort Kondracke, Executive Editor and Columnist, Roll Call

“When it comes to health care, there is no one the nation's governors have relied on more than Phil Bredesen. He knows what he is talking about, and we respect his insights and the way in which he practices what he preaches.” —Gov. Joe Manchin (D-WV)

“Governor Bredesen’s unique combination of successful experiences in both the public and private sectors gives him an important voice in our national health care debate. His stewardship of TennCare and the innovation he has brought to expanding access to underserved Tennesseans show that he is a leader whose proposals deserve careful consideration.” —Scott Serota, President and Chief Executive Officer of The Blue Cross and Blue Shield Association

“Thought provoking.” — Memphis Medical News

From the Publisher