Health Care Meltdown: Confronting the Myths and Fixing our Ailing System


It is no secret that health care in the United States is managed by a confusing welter of institutions, regulations, corporations and government agencies. Paperwork is rampant at every level, and much time and money are wasted while millions of people go without needed medical attention. For this "system" the U.S. spends about twice as much per capita as most developed countries.
In this book Dr. Bob LeBow tackles this monumental issue with clarity and forthrightness. His ...
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It is no secret that health care in the United States is managed by a confusing welter of institutions, regulations, corporations and government agencies. Paperwork is rampant at every level, and much time and money are wasted while millions of people go without needed medical attention. For this "system" the U.S. spends about twice as much per capita as most developed countries.
In this book Dr. Bob LeBow tackles this monumental issue with clarity and forthrightness. His prescription for our health care quagmire is a national health program which includes universal coverage, as is the case in every other industrialized country.
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Product Details

  • ISBN-13: 9780911469301
  • Publisher: Alan C. Hood & Company, Inc.
  • Publication date: 6/29/2007
  • Edition description: 2nd Edition
  • Edition number: 2
  • Pages: 352
  • Sales rank: 1,504,044
  • Product dimensions: 6.00 (w) x 9.60 (h) x 1.00 (d)

Table of Contents

Foreword xiii
Prologue xv
Acknowledgments xix
Introduction: Confronting the Myths: Can America Halt the Slide Toward Health Care Meltdown? 1
Our Poor Performance and Perverse Incentives
The Search for a Comprehensive Solution
Getting America Clued In
"One Risk Pool"/ National Health Insurance
Part I The Problem A Wasteful, Dysfunctional System and a Nation Kept Clueless
Chapter 1 Myths, Misinformation, and the Pursuit of Profit 13
A Myriad of Myths
Myth #1 Everybody Has Access to Care Through the Emergency Room
Myth #2 We Don't Need to Fix What's Not Broken
Myth #3 "The Market" Is the Solution
Myth #4 Private Is Always Better than Public
Myth #5 Medicare Is Going Broke
Myth #6 We Can't Afford Universal Coverage
Myth #7 Americans Don't Want Rationing of Health Care
Myth #8 We Don't Want Socialized Medicine Like in Canada
Myth #9 The Insured Pay More To Help Cover the Costs of the Uninsured
Myth #10 Universal Coverage Will Overburden Our System
Myth #11 Costs of Research and Development Drive Our Higher Drug Prices
Myth #12 We Can Get to Universal Coverage Through Incremental Changes
Myth #13 Americans Won't Accept Single-Payer Universal Coverage
Chapter 2 America's Health Care: The Monster We Have Created 47
Managed Care vs. Managed Cost: "Crazy Making"
Unrealistic Expectations
Ignorance of the Costs
The Paperwork Nightmare
Fraud and Abuse
The Paperwork Could Get Worse
(1) The "Underutilizers"
(2) The "Overutilizers"
Chapter 3 Monster II: Perverse Incentives Lead to Bizarre Outcomes 67
There's "Gold in Them 'Thar' Patients"
Creating the Demand: The Sky's the Limit
The Ultimate Overutilization: "Boutique Medicine" for the Very Rich
Opting Out: An American Privilege?
Competition vs. Cooperation
Prevention vs. Cure
The Malpractice Conundrum
Employer-Based Insurance: An Anomaly
More Perverse Incentives for Providers and Patients Alike
The Mental Health Scam
The Patient Comes Last
The Market vs. the Patient
Chapter 4 Delayed Care: Rationing American Style 90
The Mantra of "Personal Responsibility"
Some Terrible Consequences of Delayed Care
Chapter 5 Jumping Hoops for the Uninsured: Caring for Patients at a Community Health Center 97
Why They Don't Come In
The Medical Visit, Prescriptions, and Tests: Games We Play
A Patchwork of Arrangements to Get Care
Why Do Our Patients Think We Don't Have Universal Coverage?
The Positive Side of Working With the Uninsured
Chapter 6 Squeezing the Patient: Co-Pays and Deductibles 110
Why Do Physicians Support Co-Pays?
Co-Pays That Hurt
The "Safety Net" and Co-Pays
The Larger Picture
Chapter 7 Religion and Health Care Reform: "Personal Responsibility" vs. Caring for the Needy 120
How "The Market" Has Overridden Religion
The Role of "Personal Responsibility"
Free Clinics and WWJD
Health Care as a Human Right in the U.S.?
Chapter 8 Public Health: We're All on This Planet Together 130
Public Health and Chronic Disease
The New Twist to Wake Us Up: Bioterrorism
Chapter 9 Blaming the Victim: A Bad Rap for Medicare 136
Medicare as the Victim
Expanding and Improving Medicare
Chapter 10 We Don't Want a Health Care System Like They Have in Those Foreign Countries 142
Americans are Clueless on What Happens
In Other Countries
Our Much-Maligned Neighbor to the North
Our Ranking in the World
Part II Towards Finding a Solution
Chapter 11 The Price of Health: How Much Should We Americans Be Spending on Health Care? 153
The "Good Old Days" Are Over
Costs Are Going Up, Up, Up
Ethics--and Profits vs. Patients
"Expecting the World"
The Future, Technology, and Costs
The Answer Needs to Come From the People
Chapter 12 Don Quixote vs. the Establishment: Can the Medical-Industrial Complex Be Toppled? 169
"The Evil Empire": How Bad Is It?
Toppling the Windmills
Appealing to Self-Interest--Does It Have a Chance?
The Drug Barons
The Camelots of Health Care
The Lords of Medicine
Tilting at Windmills From Beyond the Medical Establishment
Chapter 13 In Search of a "Uniquely American" Solution to Health Care for All 183
Universal Uninsurance
What About Poor Folks? Charity Care to the Rescue
Potential Obstacles to Universal Uninsurance
The Sad Truth: Fantasy May Resemble Reality
Chapter 14 Grassroots for Health Care for All: What Can Americans Do to Claim a Right to Health Care? 191
Timing and the Changing Battlefield
Groups, Old and New, Promoting Health Care for All
The Community-Based Efforts
More Talk, Less Progress?
What Specific Actions Steps Will It Take to Motivate Grassroots America?
Chapter 15 National Health Insurance or Medicare for All: A Reality in Our Lifetime? 206
It's Become Fashionable to Talk About Universal Coverage
Why Don't the People Who Know Better Do Something?
The Naysayers' Logic
Chapter 16 "Single Payer Will Not Fly": A Response 216
Does "Incremental" Have a Chance?
How About Affordability for the Patient?
"Best" vs. "Better": In Search of Value for Our Money
Chapter 17 Needed for Affordable and Effective Health Care Reform in America: A Paradigm Shift for Prevention 222
A Prime Example: America's Epidemic of Obesity
What Are the Side Effects of Making Exercise "Mainstream"?
Action Steps to "Put Prevention Into America"
Chapter 18 Epilogue: Beyond Universal Coverage 234
Assuring Adequate Coverage
Reclaiming Dignity
Keeping America Clueless
The Global Picture
Steps We Must Take as a Responsible Nation to Improve the Health of Our Communities
Afterword 245
Notes 249
Selected Bibliography 261
Appendix Frequently Asked Questions About "One Risk Pool" 269
Glossary of Terms 273
Index 275
About the Author 281
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