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Don't Let Health Care Bankrupt America



We should not let health care costs undermine, weaken, and badly damage our economy. That would be a wrong, sad, and collectively incompetent thing for us to do. We are actually on that path today -– but we really do not need to allow significant levels of financial damage to happen to us.

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Chapter One

Chapter One — The Mess We Are In

Health care in America tends to be inconsistent, badly organized, often inefficient, inadequately supported by basic care improvement tools, too often both unsafe and operationally dysfunctional, deeply data deficient, and -- with all of those challenges and all of those functional problems –- far too expensive. We clearly need to improve the delivery of care in some important areas of care delivery in this country. We also need to spend less money on care.

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Chapter Two

Chapter Two — The Optimal Care System Should Be the Goal of the Business Model We use to buy Care

The most effective way of changing care delivery is to change the business model we use to buy care. We get what we pay for –- so if we want better, safer, more effective and more affordable care, we need to put in a place a business model that pays for better, safer, more effective and more affordable care.

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Chapter Three

Chapter Three — Prices Are Higher Here

Prices matter a lot.

When you look closely at health care costs for this country, the one point that stands out as the biggest single difference between us and everyone else in the world is prices.

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Chapter Four

Chapter Four — Care Delivery Is a Business

Cash flow has an incredibly powerful impact on the delivery of care.

The specific ways that we channel the flow of cash to caregivers in this country dictates almost all of the care that is delivered by those caregivers. If we want to change the care that is being delivered in this country, we will need to identify the care we want to buy, and then we need to change that flow of cash so that the money we spend to buy care will buy the care we want to buy.

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Chapter Five

Chapter Five — Someone Needs To Be Accountable for Implementing the New Business Model for Care or It Will Not Happen

Cash flow is king. The last two chapters of this book have described how the cash flow we use to buy care sculpts the way care is delivered in this country.

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Chapter Six

Chapter Six — Using Private Health Plans To Cover Everyone Will Not Work If We Can’t Make Coverage Affordable

Using private health plans to provide health coverage for most Americans will only succeed for us as a country if the coverage that is sold by the private health plans is affordable. Affordability is essential. This strategy will fail if we use private insurers to provide health coverage and the premium that is charged by the plans for their coverage is so high that people can’t afford to buy the coverage.

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Chapter Seven

Chapter Seven — We Can’t Allow Government-Funded Health Care To Cripple our Economy

We really cannot afford to allow the health care costs that are being incurred by our Medicare and Medicaid programs destroy our state and federal budgets and seriously damage our economy. That is the path we are on today. It is clearly the wrong path to be on.

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Chapter Eight

Chapter Eight —  We Need To Make Medicaid Better, Smarter, and More Affordable As Well

More than 45 percent of the babies who were born in this country last year were born to mothers who were covered by Medicaid.

For a number of states, including California, the majority of babies who were born were the children of Medicaid enrollees.

Medicaid is clearly at a key logistical position relative to the future of this country. Our children are our future, and very soon a majority of our children will now have their births financed by our Medicaid Program.

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Chapter Nine

Chapter Nine — Let’s Cut Costs By Improving Health

We would spend a lot less money of health care in this country if people were healthier. That is pure common sense. The cost of care is created by the need for care. If we didn’t need care, we wouldn’t need to spend our money getting and using care.

Those are very basic points to consider. They are simple truths that we too often overlook as we focus on how to make care better and more affordable.

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Bibliography — Endnotes


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