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Who Killed Healthcare?: America's $2 Trillion Medical Problem - And the Consumer-Driven Cure: America's $1.5 Trillion Dollar Medical Problem--And the Consumer-Driven Cure
In the battle for U.S. health care, patients and doctors are losing.
Who Killed Health Care? shows how to win the war.
One of the nation's most respected health care analysts, Regina Herzlinger exposes the motives and methods of those who have crippled America's health care system-figures in the insurance, hospital, employment, governmental, and academic sectors. She proves how our current system, which is organized around payers and providers rather than the needs of its users, is dangerously eroding patient welfare and is pushing costs out of the reach of millions.
Who Killed Health Care? then outlines Herzlinger's bold new plan for a consumer-driven system that will deliver affordable, high-quality care to everyone. By putting insurance money in the hands of patients, removing the middleman in the doctor-patient relationship, and giving employers cost relief, consumers and physicians will be empowered to make the system work the way it should. Herzlinger describes in precise detail how her innovative program will provide
Smaller, disease-focused medical facilities that provide complete care for patients
A national system of medical records that provides privacy with confidential access by approved practitioners
Mandatory performance evaluations of all hospitals and all other medical organizations
Mandatory health insurance with subsidies for those who cannot afford it
Who Killed Health Care? is a call to arms that must be answered; the welfare of every American hangs in the balance.
"A brilliant analysis... A must-read." - Bill George, Professor, Harvard Business School and Former CEO of Medtronic
"As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written." - Daniel H. Johnson, Jr. MD, former president of the American Medical Association
"Regina Herzlinger's ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system's existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control." - Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass)
"Regina Herzlinger... offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?" - Greg Scandlen, founder, Consumers for Health Choices "Regi Herzlinger has brilliantly articulated a better way - embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans - not politicians and bureaucrats - back in charge of their health care decisioins." - U.S. Senator Tom Coburn (R-Okla), M.D. "Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out." - Dennis White, executive vice president for strategic development, National Business Coalition on Health "A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly." - James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine "You can practically hear the war chants as Professor Herzlinger sets out her view of what's wrong with the health care system and how to fix it. You'd best read it so you can decide which side you will be on when the battle is joined." - Paul Levy, CEO, Beth Israel Hospital, Boston, MA "Regina Herzlinger, the nation's leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read." - Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership "You don't have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care." Peter L. Slavin, MD, President, Massachusetts General Hospital
Who Killed Health Care? shows how to win the war.
One of the nation's most respected health care analysts, Regina Herzlinger exposes the motives and methods of those who have crippled America's health care system-figures in the insurance, hospital, employment, governmental, and academic sectors. She proves how our current system, which is organized around payers and providers rather than the needs of its users, is dangerously eroding patient welfare and is pushing costs out of the reach of millions.
Who Killed Health Care? then outlines Herzlinger's bold new plan for a consumer-driven system that will deliver affordable, high-quality care to everyone. By putting insurance money in the hands of patients, removing the middleman in the doctor-patient relationship, and giving employers cost relief, consumers and physicians will be empowered to make the system work the way it should. Herzlinger describes in precise detail how her innovative program will provide
Smaller, disease-focused medical facilities that provide complete care for patients
A national system of medical records that provides privacy with confidential access by approved practitioners
Mandatory performance evaluations of all hospitals and all other medical organizations
Mandatory health insurance with subsidies for those who cannot afford it
Who Killed Health Care? is a call to arms that must be answered; the welfare of every American hangs in the balance.
"A brilliant analysis... A must-read." - Bill George, Professor, Harvard Business School and Former CEO of Medtronic
"As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written." - Daniel H. Johnson, Jr. MD, former president of the American Medical Association
"Regina Herzlinger's ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system's existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control." - Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass)
"Regina Herzlinger... offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?" - Greg Scandlen, founder, Consumers for Health Choices "Regi Herzlinger has brilliantly articulated a better way - embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans - not politicians and bureaucrats - back in charge of their health care decisioins." - U.S. Senator Tom Coburn (R-Okla), M.D. "Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out." - Dennis White, executive vice president for strategic development, National Business Coalition on Health "A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly." - James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine "You can practically hear the war chants as Professor Herzlinger sets out her view of what's wrong with the health care system and how to fix it. You'd best read it so you can decide which side you will be on when the battle is joined." - Paul Levy, CEO, Beth Israel Hospital, Boston, MA "Regina Herzlinger, the nation's leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read." - Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership "You don't have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care." Peter L. Slavin, MD, President, Massachusetts General Hospital
312 pages, Hardcover
First published April 17, 2007
16 people are currently reading
241 people want to read
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Displaying 1 - 23 of 23 reviews
May 30, 2011
For those who have some understanding of the U.S. healthcare system, this is well written book that lays out the case for consumer-driven healthcare. Herzlinger does an effective job of framing the roles of each player, describing their incentives and limitations, and crafting a path to a less expensive and higher quality system focused around the consumer (or patient). The only negative I found, was that Herzlinger has a tendency to make the same point multiple times. I think this is in an effort to ensure points are not missed. This gets frustrating at times, but she doesn't waste too much space and typically has an interesting spin or comparison to drive her point home. Overall, a high quality read.
This entire review has been hidden because of spoilers.
March 16, 2024
As of my reading, the book is dated (so much has changed in the healthcare system, most notably the ACA) but the ideas laid out by the author are still applicable. The book offers a solid analysis of what's wrong with health care (who killed it) and provides a good case for consumer-driven health care.
November 7, 2017
- Very happy I read this book. It helps me so much to understand American healthcare system which is very beneficial if you are also an active investor like me.
- Great writing skills, well-constructed
- Not only did Herzlinger point out the problems but also a concrete solution for execution.
- Must read!
- Great writing skills, well-constructed
- Not only did Herzlinger point out the problems but also a concrete solution for execution.
- Must read!
July 2, 2017
This book is still relevant today and a must read for anyone trying to change the healthcare industry for the better.
September 9, 2016
This is a spicy indictment of the players who've contributed to mucking up our healthcare system, including the health insurers, the general hospitals, the employers, the U.S. Congress, and the academics who support the legacy top-down system. It turns out that Uncle Sam is an exceptionally poor doctor, and the government should really just stick to its role in ensuring solvency, fairness, integrity, transparency, and care for the very poor, and step far back from trying to ration care or prescribe protocols that physicians are far better equipped to develop. Entrepreneurs must be allowed to succeed in bottom-up fashion, and the citizenry should have cost and performance comparison information about providers as in any other consumer-driven market.
Here are some key points to remember:
--Markets are equilibrated by marginal consumers, or the discerning, last-to-buy (market clearing) group of picky and assertive people. They drive prices down and performance up for the rest of us.
--She proposes five ways to achieve a more consumer-oriented market: 1. Everyone required to buy his or her own insurance using tax-sheltered income, 2. Government subsidizes the very poor in buying insurance, 3. Providers free to bundle care as they want to and quote their own prices, 4. Government requires publication of data on the performance of all medical providers, and 5. Prices are risk adjusted by payers.
--Nonprofit hospital systems often feature sky-high salaries, profits, and cash balances that are plowed into overly aggressive expansion instead of care for the poor, or lower prices for patients generally.
--A concrete example of Congress stacking the deck is in kidney care when they responded to Amgen's extremely high investments in lobbying to: 1. Void functional equivalence, 2. Provide for the continual expansion of required hematocrit levels in ESRD patients, and 3. Giving Amgen an orphan drug monopoly over epo. This all results in much higher costs with much lower quality for all kidney patients in the U.S.
--Consumer-driven healthcare will encourage 3 major supply-side innovations: 1. Focused factories that bring specialists and generalists into one integrated "stop-and-shop" system of care, 2. Personal electronic health records, and 3. personalized medicine.
Here are some key points to remember:
--Markets are equilibrated by marginal consumers, or the discerning, last-to-buy (market clearing) group of picky and assertive people. They drive prices down and performance up for the rest of us.
--She proposes five ways to achieve a more consumer-oriented market: 1. Everyone required to buy his or her own insurance using tax-sheltered income, 2. Government subsidizes the very poor in buying insurance, 3. Providers free to bundle care as they want to and quote their own prices, 4. Government requires publication of data on the performance of all medical providers, and 5. Prices are risk adjusted by payers.
--Nonprofit hospital systems often feature sky-high salaries, profits, and cash balances that are plowed into overly aggressive expansion instead of care for the poor, or lower prices for patients generally.
--A concrete example of Congress stacking the deck is in kidney care when they responded to Amgen's extremely high investments in lobbying to: 1. Void functional equivalence, 2. Provide for the continual expansion of required hematocrit levels in ESRD patients, and 3. Giving Amgen an orphan drug monopoly over epo. This all results in much higher costs with much lower quality for all kidney patients in the U.S.
--Consumer-driven healthcare will encourage 3 major supply-side innovations: 1. Focused factories that bring specialists and generalists into one integrated "stop-and-shop" system of care, 2. Personal electronic health records, and 3. personalized medicine.
August 4, 2014
There is so much wrong with the argument of this book it is hard to decide where to start. First, the author is pandering and pedantic throughout. I found it difficult to take her seriously when referring to President Nixon as the Prince of Darkness several times. Beyond that, she uses the word us as if to include herself in the populace and not one of the academics, except that she is. One of her central villains are academics, but she conveniently paints herself as not one as if maybe saying she is one of us often enough will make you forget except that at other times she relies on her authority as one. That is actually part of her broader problem, she disagrees with herself a lot. Scientists and statistics shouldn't tell doctors what to do, but doctors should practice evidence based medicine. I am sure if you are unfamiliar with the terms her bait and switch is easier to get past you as she is careful to switch between equivalent terms when decrying it and when praising it.
More than her writing style and tactics, some of what she says is just wrong. Consumers buy healthcare not health looking at health outcomes and making decisions about good healthcare is problematic and is not a secret plot against American consumers. It is a real problem and it is totally ignored in her vitriolic story of insurers and hospitals trying to hide behind regulations when not providing outcomes data. Yes, healthcare is a service industry, but it is not just like Dell computers as she would have you believe. I can return a computer, I can assess whether I want the extra processing speed for $x. You can't do this when deciding on a surgery or a drug therapy, the procedure is done that state of health is gone once that procedure happens with no way to get a doover like with a computer. Processing speed is easy to quantify and value. Potential side effects and benefits and risk in tiny percentages are not.
Lots of flash no substance and some total errors. Do not recommend to anyone!
More than her writing style and tactics, some of what she says is just wrong. Consumers buy healthcare not health looking at health outcomes and making decisions about good healthcare is problematic and is not a secret plot against American consumers. It is a real problem and it is totally ignored in her vitriolic story of insurers and hospitals trying to hide behind regulations when not providing outcomes data. Yes, healthcare is a service industry, but it is not just like Dell computers as she would have you believe. I can return a computer, I can assess whether I want the extra processing speed for $x. You can't do this when deciding on a surgery or a drug therapy, the procedure is done that state of health is gone once that procedure happens with no way to get a doover like with a computer. Processing speed is easy to quantify and value. Potential side effects and benefits and risk in tiny percentages are not.
Lots of flash no substance and some total errors. Do not recommend to anyone!
July 28, 2011
Herzlinger does a good job outlining the steps that need to be taken to fix the current broken healthcare system by suggesting we more or less following the Swiss model. This consumer driven model would enable innovators who have feasible ideas about how to get more value for the money to enter the market and allow providers compete for your business. My only issue was the redundancy which seemed to make the flow to be a little choppy. Overall it was a fairly good book.
January 16, 2008
Very good way of looking at the problems involved in health reform: health care has so many major stakeholders which all say they are dedicated to patients - and YET, patients are underserved -- not by any of them solely, but by ALL of them COLLECTIVELY. Reform has to be collective-comprehensive AND driven by patients-as-consumers.
August 6, 2008
If you want to learn what's wrong with health care and who's killing it, read this book. I don't agree with all of her recommendations (just most of them).
I also heard Regina talk when she was in Utah. My key concern is that even though she opposes government mandates, she thinks some are necessary in health care. Big disconnect.
I also heard Regina talk when she was in Utah. My key concern is that even though she opposes government mandates, she thinks some are necessary in health care. Big disconnect.
April 29, 2011
Provides a somewhat objective analysis of issues facing our health care system. examined the shortcomings of all stakeholders including providers, insurers, insureds and regulatory agencies. Not a fan of 'consumerism' in healthcare. Afterall, the crux of free market theory relies on rational choice.
February 7, 2008
How government intervention made health care more expensive and unavailable to the average consumer. OUTLINES A CONSUMER DRIVEN HEALTH CARE SYSTEM THAT DELIVERS QUALITY AFFORADABLE CARE FOR EVERYONE. A MUST READ.
April 6, 2008
Very informative book about Health care and the problems that our system faces today! The solution this harvard business school professor comes up with: consumer driven health care! (NOT UNIVERSAL!!)
November 7, 2011
Dr. Herzlinger brings a bias to the conversation, but who doesn't? She does a great job of explaining the problem in an easily digestible format and humanizing the problem so it immediately feels like one we all share.
April 9, 2009
Still working on it...
May 17, 2008
Meh.
Annoying tone of voice.
Topics were too dumbed-down.
No exceptionally novel ideas on how to solve issues.
Annoying tone of voice.
Topics were too dumbed-down.
No exceptionally novel ideas on how to solve issues.
Read
March 2, 2008Just started it...it's good so far but I'm skeptical about the answers she proposes...I'll let you know.
May 24, 2008
Too vitriolic and polemical. I stopped after 30 pages.
August 12, 2009
Deficient. Adolescent. Too many times I felt like the author was pleading with me: "Stay with me here!"
November 7, 2009
Its message is above criticism. Its writing however is laborious.
December 19, 2012
Read half of it. So uninteresting I couldn't even finish.
October 11, 2011
Although the concepts that she aims to get across are decent, both her tone and delivery needs some work.
October 12, 2015
repetitive but informative
Read
November 16, 2017This book was written in 2007. A lot has changed in health care since then but it does offer some good background.
Displaying 1 - 23 of 23 reviews