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The Long Fix: Solving America's Health Care Crisis with Strategies that Work for Everyone

4.16  ·  Rating details ·  220 ratings  ·  40 reviews
Beyond the outrageous expense, the quality of care varies wildly, and millions of Americans can’t get care when they need it. This is bad for patients, bad for doctors, and bad for business.

In The Long Fix, physician and health care CEO Vivian S. Lee, MD, cuts to the heart of the health care crisis. The problem with the way medicine is practiced, she explains, is not so mu
Hardcover, 304 pages
Published May 26th 2020 by W. W. Norton Company
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Mary Thomas
Nov 15, 2020 rated it liked it
Always happy to hear physicians in positions of power who recognize we need deep change in our healthcare system and bring the absurdities of the U.S. healthcare system into the light for the public. However, I don't think she goes far enough. I disagree with her fundamental premise that "It doesn't matter who is paying, but what they are paying for." As a self-righteous med student, this is a position that I cynically expect coming from a sub-specialist and CEO as opposed to a physician working ...more
Aug 01, 2020 rated it it was amazing
While it's easy to complain about how broken the American health care system is, it feels almost impossible to fully grasp the scale of the problem. This book did an excellent job bringing insight to every single problem the system face, and more importantly how to fix it. The author's hopeful outlook on the future was refreshing to read compared to the media's narrative around this issue.
Jul 02, 2020 rated it it was amazing
If you are looking for an optimistic view on the push for value based healthcare this is a good read. Book is filled with great anecdotes, insightful stats, and actionable steps to improve US healthcare.
Nov 27, 2020 rated it it was amazing
Shelves: non-fiction, health
I'm reading this book as I prepare for an interview at my top choice medical school. As prep material for such a high-stakes interview, I recommend this book. It will get you thinking on topics that are hugely important in the medical industry, from medical error to treatment costs. It does have its blind spots; as another reviewer said, the strength of "The Long Fix" is not tackling healthcare inequity. Lee's battle hymn is inefficiency and unnecessary expense, but the dots could easily be conn ...more
Catherine Sullivan
Oct 21, 2020 rated it it was amazing
Sold. I want these changes and I want them now! Not just for me and my loved ones, but for all of America. No more pay-for-action, please give us pay-for-results. If I go to the doctor with a complaint, I prefer a good diagnosis instead of all the unnecessary testing. I’ve been on that treadmill before, and it wasted my time and money and was very anxiety-causing. I appreciated Lee’s breakdown analysis of all the different parts of our healthcare system, and giving us actionable steps to impleme ...more
Dec 11, 2020 added it
Vivian Lee has an interesting perspective to share—she's worked as a radiologist, CEO of University of Utah Health, and now President of Alphabet's Verily Health Platforms.

This book covers some of the problems Lee identifies in the US healthcare system as well as some of the places where changes are working (or might work?). She's cautiously optimistic in spite of what reads to me as a bad situation with no sign of the market facilitating changes on their own and no few intimations of support f
Oct 15, 2020 rated it it was amazing
Must read for every US citizen to understand our health system and the role each of us can play (there are concrete recommendations) in improving it.
Sandra Lundblad
Sep 13, 2020 rated it it was amazing  ·  review of another edition
Awesome Read

This book is a positive, understandable overview of our healthcare system. The fix to a better care/ better outcome system that also saves money and lives laid out in simple precise detail . Excellent read!!
Jul 31, 2020 rated it it was amazing
I highly recommend this book as a concise and informative book on fixing the healthcare system in America. Lee takes a nonpartisan approach and offers recommendations for cost cutting and improving care. She provides historical perspective to explain how we got in the mess we are in. She advocates for a use of data to improve care, reduce errors, and standardize treatment methods for various medical conditions. She also calls on all of us to “coproduce” our health with physicians and focus on st ...more
Theresa Barton
Oct 19, 2020 rated it liked it
Shelves: reviewed
Optimism despite: Medical mistakes are the 3rd largest cause of death in the USA! Radiologists miss 30% of irregularities in a scan! Medication error (wrong dose, wrong time, wrong...patient) occurs at a rate of 1 per patient per day! Our 'zero gravity' healthcare costs are undermining the vitality of Our American Economy, for instance GM spends $71/worker/hour on health insurance! ...more
Paul Sand
Sep 27, 2020 rated it it was ok

[Imported automatically from my blog. Some formatting there may not have translated here.]

Every so often, I get it in my head to read a book about the American health care sector. (Also to beat my head against a concrete wall for a few hours, but that's not important right now.)

By the way: calling it a health care "system" is something I will try to avoid. The very language seems to presume something that's the result of design, instead of (more accurately) a sector that's been kludged over d

Craig Becker
Nov 11, 2020 rated it really liked it
Dr. Lee's book, "The Long Fix" provides a good insiders view of the health care. Insider because she ran health organizations. It of course was disturbing to see how often revenue is prioritized over health and care in the system. As has been noted often, a bad system beats good people every time. She clearly explains how this bad system beats good health care providers because it leads to less care than should be provided and or outrageous charges. As she notes, the problem is the Fee-For-Servi ...more
Rohan Dalvi
Jun 15, 2021 rated it really liked it
Great overview of the issues confronting the US healthcare system, as well as the solutions that various players in the industry are trying to implement.

It begins by diagnosing the shortcomings of American healthcare from a macro perspective – the egregious prices, high amounts of waste, medical errors, high admin spend, overtreatment, etc., which the author attributes to the fee-for-service system. (I think this is not super controversial of an opinion nowadays.) She dives into this and explain
Nicole Harris
Jun 21, 2021 rated it it was amazing
I used to suffer from HERPES GENITAL for about 3 years so I can relate to people who have the cure. No medications or treatments ever really did anything for me (i tried them all no one worked. but I was actually able to completely cure HERPES naturally after countless hours of online research. What worked for me is as follows: I saw  Dr Oje Abacha Information online that he normally cure and treat disease and infirmities with his Herbal Medicine, I never really believed the people who were reco ...more
Nov 17, 2020 rated it it was amazing
Vivian Lee wants to transform the US health care system into one the rest of the world would envy. She's been the CEO of hospital systems and has been on the front lines of trying to improve efficiencies, incentivize the right behaviors, put technologies in the right places, and tweak the regulations to better tune the whole system. All that and more in this well-organized, informative, easy to read, hopeful, and helpful book.

I ran some of the ideas in this book by my family members who are cli
Apr 12, 2021 rated it it was amazing
I know next to nothing about healthcare, but this was a short and accessible introduction to what is wrong with America's health care system and the direction towards which Dr. Vivian Lee thinks it should go. The tl;dr is that healthcare in America should shift from a fee-for-service model to value based care model. (There are also a lot of other things that also need to be addressed, but that was my primary takeaway from the book.) There are many illustrative case studies of different hospital ...more
Dec 05, 2020 rated it liked it
More 101 than I was expecting but some good chapters; I especially enjoyed the chapter on military health care. It wasn’t clear to me who the desired audience is, I appreciated the specific actions suggested at the end of each chapter but it seemed almost incongruous with the more basic information delivered throughout the book. The suggestions were geared toward audiences (payers, providers) that would already be familiar with most of the content. I was hoping for a more advanced dissertation, ...more
Cameron Casey
Jan 29, 2021 rated it really liked it  ·  review of another edition
Interesting and comprehensive. This book doesn't get into the tiny details but the instead the broad strokes of problems with examples. Every chapter ends with what we should do with specifics. This is also easy to read and understand some of the problems facing us and just how hard they will be to change. Working in health care, this book just makes me angry because I a personal story of all her examples.

Here is to a long, long fix.
Nov 15, 2020 rated it it was amazing
This book should be required reading for every health policy student and health care professional. It is wonderfully written, has great examples, and it gives concrete examples of the challenges and opportunities in our health care system. This may be one of the best health care policy books I have ever read.
Deborah Stevens
Dec 26, 2020 rated it really liked it
Shelves: medical
I appreciated this book for its focus on the fixes for the myriad problems in American healthcare that are detailed elsewhere.

Lee also highlights a few corners of healthcare that she finds already working better; chiefly, Medicare Advantage.

I listened to this on audio and in retrospect think I would have been able to better engage with a print copy.
Jan 26, 2021 rated it really liked it
Great discussion of the problems with the American healthcare system, and why it is so expensive, without corresponding superlative quality. The book is accessible, while being well- researched, definitive, and informative. A great resource with strong and reasonable recommendations for systemic improvements.
Valay S
Feb 22, 2021 rated it liked it
Two-sentence summary of the book. The U.S. healthcare system is not optimally structured and recent reforms have fixed a few things but opened up new things that require attention. The solution is to pay for outcomes and not action. The first few and last chapter are impactful and resonating but the author's narrative drags in between. ...more
Sam Baldazo
May 28, 2021 rated it really liked it
Listened to audio book. It was pretty interesting, full of stories leading to good takeaways for improving health care. It did get a little slow, but that could be that I already have exposure to this field and it was more introductory. Definitely recommend to anyone wanting to understand the starting points for value based health care.
David Parker
Oct 21, 2020 rated it really liked it
Shelves: book-club
I love the general breakdown the author provides with regards to each and every little thing that needs too change to fix America's healthcare system.

That said, even with her sense of understanding and optimism, I just don't have faith any of it can actually happen.
Nov 22, 2020 rated it it was amazing
Lee is about the most-qualified author I could imagine to write this book and she did an incredible job outlining the magnitude of the American healthcare crisis and what can be done to fix it. Very quick read. Highly recommend!
Lynn Sherman
Dec 02, 2020 rated it liked it
Well written and easy to read. This was a compilation of many ideas, most of which we have heard before. It did not go far enough to be creative about solutions. Definitely worth a read to organize ideas about health care. However, written from the for profit provider point of view.
Jan 08, 2021 rated it really liked it
Anyone who's had any experience with government beurocrocy will find sections of this book a bit too optimistic, but it's still a very interesting and valuable read on ways we can improve the quality of the healthcare system. ...more
Jan 24, 2021 rated it really liked it
The author outlines a blueprint for change while highlighting advances in healthcare delivery and the many positive programs that exist today. It’s a useful guide to healthcare today for anyone who wants to speak competently to the many forces impacting care delivery, quality and cost.
Carmen Witsken
May 13, 2021 rated it really liked it
Enjoyed reading her critical but optimistic view of the US healthcare system. I wish she had discussed more outcomes-based systems present today and included ways providers can advocate for these changes
Stevie Dunton
May 18, 2021 rated it it was ok
Stopped at 12%. I wanted it to go more in depth but it was just like listening to a few decontextualized sound bytes. I felt like i wasn't really learning anything, which is never what I want from a non fiction book. ...more
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