Author: Richard L. Reece
Publisher: Greenbranch Publishing – 290 pages
Book Review by: Nano Khilnani
Although this book is on a very serious subject that causes much financial pain to millions of companies, families and individuals, the author injects humor into it at many places to help readers enjoy it.
The cover itself makes you chuckle. It depicts a complex, colorful, detailed drawing of a maze with large, medium and small circles, different sizes of squares in different colors, and various sizes and colors of rectangles as well. There is a cross, a hexagon, a triangle, and even a seven-sided star. All the shaped objects have labels on it, perhaps names of government agencies or titles of government bureaucrats and functionaries. Amidst this distressing maze are lines drawn within, signifying random relationships among the entities involved.
The most laughable characteristic of this maze representing the “Obama Care” system created by the health care bill passed by our Congress a few years ago is that while there a large entrance to “Your New Health Care System,” there is no exit from it!
The author of this book – Richard L. Reece, MD – has written 11 books on the U.S. health care system. He comments on patient concerns, physicians’ mindsets and our culture on the one hand, versus the complexities of the health care arena in America today, with the immense number of laws and regulations that confound and confuse us.
Such complexity already existed before the health care bill – known as the Patient Protection and Affordable Care Act or PPACA – became law about two years ago in March 2010. About nine months later, the law was ruled unconstitutional because the provision mandating that every person must buy health insurance whether he or she can afford it or not, and wants it or not – was a violation of individual rights guaranteed under the U.S. Constitution.
Dr. Reece points out to surveys that show about 60 percent of the people are opposed to the new health care law due to various reasons. One of them is that instead of becoming “affordable” as the law is labeled, the cost of health insurance may continue to rise and remain unaffordable for some 40 million uninsured people in America.
This book is basically a collection of essays written and published in the past and currently. It is organized into three parts.
Part One, entitled “Culture and Politics, the Reform Law, Costs and Demands, and Unforeseen Consequences,” deals with topics ranging from attitudes about health care reform to current health care laws in several states (e.g. Massachusetts and Indiana “experiments”) to what types of health care exist in other nations and statistics on them.
Part Two, “Physicians, Hospitals, Patients, Access to Doctors, Medicare, Government Bureaucracy,” presents problems that each of these entities face, as seen by Dr. Reece in his long years of experience as a physician.
Part Three, “Innovations, Electronic Health Records, the Internet and Social Media, and Miscellany,” discusses issues such as government “innovation,” whether EHRs are a bonanza or a boondoggle, and how the Internet and social media has changed public views of health care.
The Epilogue has four sections that present proposals on how the U.S. health care system can become less complex, less impersonal or less in the hands of government bureaucrats (more human), and most important, affordable.
Dr. Reece writes that Democrats called the health care law passed in early 2010 as an “historic achievement,” but Democrats characterized it as a “monstrosity.” He quotes one person who aptly described the “Obama Care” bill as “2500 pages of undecipherable and unreadable legal graffiti, confetti, gibberish, and legislative sausage.”
“But in the haste to pass it, legislators, perhaps emboldened by their unchecked majority status and sensing an opportunity to cement their legacy, may have overlooked untoward consequences. They created profound uncertainties in a health care industry that comprises one-sixth of the American economy and that has created more jobs in the last three years than any other economic sector,” Dr. Reece points out.
He mentions other problems Americans face besides the soaring prices of health insurance have made it an extremely difficult period for hundreds of millions of us. Among these are the current recession and business slowdown, the loss of millions of jobs and the difficulties of getting them, the soaring national debt and repeated raising of the debt limit, and constant overspending by state governments and property tax increases.
In contrast to this, Dr. Reece points out to trends in health care wherein physicians and hospitals are solving the problem of rising operational costs through consolidations.
There are eight such trends, namely: the rise of ACOs or accountable care organizations; consolidation at every level in the health care system; bundled payments between hospitals and physicians; the decline of private practice, especially of small groups; hospital and physician initiatives decentralizing care; concierge medicine; the electronic revolution; and patient involvement in care.
There are three other sections in the Epilogue I urge you to read for your benefit: Doctors Make a Difference for the Poor; The Doctor Is In: and Ten Wrap-Ups for the Health Reform Maze. Dr. concludes this book by pointing out that surveys indicate that 90 percent of doctors feel they have been excluded from the health care reform process.