“Who Killed Health Care” by Regina Herzlinger. The book is divided into three parts. The first two parts assess our present health care system and the reasons it is so expensive, 2 TRILLION dollars and ineficient at covering our people. These are worth reading for anyone trying to understand the successes and failures, well mostly failures, of this system. The author does a great job showing us how things were cobbled together to get us into the mess we are in, from greed to government interference and bungling. It is easy to see how money is power and how it influences health policy. Our policies have been shaped more by special interest with money than sound medical science or even concern for patient well being.
In the third part of the book she tries to explain to us about the solution for our out of control system and that is Consumer Driven Health Care and she falls short. She uses limited examples of success that I don’t think apply to the health system in general. Can we care for chronic disease in the same way that a surgeon repairs a hernia? She compares public consumption of consumer goods like cars to how we use and ought to use health care. Are the two markets comparable? You will see the term “focused factory” a lot, and how using these factories to treat chronic disease will improve care and save money. Factories may be fine when you are building hundreds or thousands of identical products. They are not so fine when you are trying to craft an individual item that is unique the way each of us and our medical needs are unique. Sure the diseases we have are similar but each of us is not and our health care needs to be individualized for us. It is also easier to control cost and quality when thinking about a factory where the point of interaction is well defined, the environment controlled and you are producing trinkets or cars. In actuality medical care is crafted for the individual one visit at a time.
The last chapter, on laws and their legislators, summarizes things pretty well.
All in all a great read, very good on history and perspective, weak on the solution. It is useful to put what I have learned from this book together with other books and ideas on the topic. So far no magic bullet for the problem,
