America spends more than any other developed nation on healthcare2.1 trillion in 2007 alone. But 47 million Americans remain uninsured, and of those Americans who are insured, many suffer from poor health. In his ground-breaking proposal, Dr. Ezekiel Emanuel offers up a plan to comprehensively restructure the delivery and quality of our healthcare. By eliminating employer-healthcare and establishing an independent program to evaluate healthcare plans and insurance companies, he offers a no-nonsense guide to how government can institute private insurance options that will allow each of us a choice of doctor and plan.
With the rate of healthcare costs rapidly outpacing our gross domestic product, we can no longer afford to maintain our fragmented delivery of care, or entertain reforms that seek to patch, rather than cure, a fractured system. Accessible, straightforward, and revolutionary in its approach, Healthcare, Guaranteed is an inarguable guide to lasting healthcare reform.
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About the Author
Dr. Ezekiel Emanuel is the Chair of the Department of Bioethics at the Clinical Center of the National Institutes of Health and a breast oncologist. A visiting professor at the UCLA, John Hopkins Medical School, and Stanford Medical School, and the author of several books, he lives in Evanston, Illinois.
Most Helpful Customer Reviews
As a retired private practice physician, I read and highly recommend Ezekiel Emanuel's book Health Guaranteed. The author is a practicing physician (breast oncologist) who outlines a very well thought-out system to fix many of the problems with our health care system. He compares the plan he and Victor Fuchs have designed, Guaranteed Healthcare Access, to other types of reform that have been proposed for the USA (incremental reform, mandates, and "single payer"). He also explains briefly how we arrived at our health care delivery and financing system. Furthermore, he explains that it is the system, not the individuals who work within the system, that is to blame for the serious flaws. A major problem with our system is the reliance on employers for financing. If you do not see the problem here, the book explains it. Another major problem is the reliance on a fee-for-service system. While this criticism traditionally gets huge hoots from practicing physicians, his arguments are very difficult to dispute. He further argues convincingly that this program is superior to any other proposal, and that establishing it piecemeal will not be effective. I was convinced that more of the same will eventually bankrupt us.
Incoming Presidential Chief-of-Staff Rahm Emanuel's smarter brother's proposal includes: 1. guaranteed coverage (mandates and incremental reform fail here) 2. effective cost controls (mandates and incremental reform fail here, too) 3. high quality coordinated care (incremental reform unlikely be effective; mandates and "single-payer" fail here) 4. choice of plans and providers (incremental reform and mandates only help some here, "single-payer" doesn't) 5. fair funding (mandates and incremental reforms fail here, and no fair funding proposal has been proposed for single payer) 6. reasonable dispute resolution (no such solution has been offered with mandates, single-payer, or incremental reforms, and here even Emanuel's plan is not bullet-proof) 7. economic revitalization (none of the other plans address this adequately) Emanuel and Fuch's GHA proposal completely removes healthcare financing from employers, freeing them to do what they do best.
Dr. Emanuel answers so many questions that I cannot start to list them here. I kept reacting "yeah, but what about...?" and then he would answer. My only complaint is that for as short as the book is, it could have been much shorter, given the content. It is very repetitive, but I understand that part of its design must be to sell an idea which has been presented and refined in recent years. I do wish he had compared and contrasted it with the existing systems of other developed countries (especially recently designed ones like Taiwan and Switzerland), but I will have to find that information elsewhere.
Given his connections, I trust that he will be given an opportunity to try to sell his plan to HHS Secretary-designate Tom Daschle, since it appears that Daschle's plan (I haven't read his book yet) is only an incremental reform plan, the likes of which Emanuel convincingly argues have always failed to solve the serious problems of our healthcare finance and delivery system.
Dr. Emanuel does a wonderful job of presenting many of the problems the current American health care system faces, and he puts forth a number of well thought out and eloquently presented solutions. The book is short enough for the casual reader, but broad enough to give the reader an understanding that is not limited only to a certain portion of health care.
Although, as forward by Victor R. Fuchs states, "The devil is in the details", Dr. Emanuel did not seem to provide the reader with enough details regarding the implementation of many of his solutions. For example, Dr. Emanuel expresses a need for "High-Quality, Coordinated Care" in American health care, but he fails to express exactly how The Guaranteed Health Care Access Plan (his proposed solution to the current health care mess) would provide for it.
That flaw aside, Dr. Emanuel is a credible author who comes from the health care field. He has many innovative and feasible ideas, and he proposes a well thought out plan to clean up the American health care mess.