Question: Who is the intended audience?
Answer: The intended primary audience is the American public. There are a number of misconceptions about health care in their mind, for example, that doctors set their own fees when in fact Medicare and other third parties set the fees. Caregivers are a secondary audience, and in the book, I seek to give their point of view.
Q: What is the book about?
A: It is about the prospects of proposed health reform, Obama style, passing. And if it passes and in what form, will it be a historic legislative monument or a political monstrosity? The book is respectful but skeptical about the changes for passage. As I write, only 42% of Americans approve of President Obama’s handling of health reform. My guess, as expressed in the book, which was finished in April, is that President Obama will get about 1/3 of what he wants.
As expressed in the book President Obama faces four major reform obstacles. I call them the four “Cs.”
• Culture American style, abhors the word “rationing.” Our health care culture cherishes unlimited choice, quick access to the latest and best in medical “cures,” and proven lifestyle restoring technologies. These traits conflict with a centralized, command-and-control, federal expansion of health care.
• Complexities American health care is a whirling Rubik’s Cube, with millions of interrelated moving parts, institutions, and people, each with agendas, axes to grind, and oxen to gore.
• Costs Obama says prevention, electronic medical records, and paying only for what works, as established through comparative research, will save billions of dollars, yet scant evidence exists that these measures work. Proposed savings remain hypothetical. The estimated cost of the current Democratic health exceeds $1 trillion over the next decade and will likely be more.
• Consequences of curtailing health costs, may be worse than the cure, because health care institutions and private practices in many communities are the biggest and fastest growing employer in town. Collectively, health care profoundly impacts most communities’ economies. Health care’s building blocks can’t be downsized quickly or dramatically.
To these obstacles I would now add public concern over the projected $9 trillion deficit in 10 years, the dreadful state of the economy, the 10% unemployment figure as more overriding concerns than health reform, and the recent defeats in government races in Virginia and New Jersey, which may cause the Blue Dogs to vote against House and Senate health reform bills.
Q: Why are you the best person to write this book?
A: Because I am a physicians who been writing on this subject for 35 years – as editor-in-chief of Minnesota Medicine, The Reece Report, and Physicians Practice Options – for 35 years. Also I’ve written 10 books on various aspects of the medical system. In the last two years, I’ve published three books: Voices of Health Reform, Innovation-Driven Health Care: 34 Keys to Transformation, the Obamacare book, and 1060 blogs in Medinnovationblog. The blog focuses on medical innovation and health reform. During the course of these writings, I’ve interviewed over 300 health care authorities and participants and have captured their words in print interviews.
Q: How is this book different from other books on this topic?
A: The book is different because it highlights several things you haven’t heard in the health care debate. 1) Doctors are demoralized and departing from or not entering the ranks of primary care at an accelerating rate; 2) it reports the results of a survey of 300,000 primary care doctors which explores the reasons for physician discontent; 3) it explains the impact of the internet on health care; 4) it points out that health care is a vibrant industry that employs 14 million Americans and is one of the few growth sectors of the American economy; 5) it delineates why the American medical system compares favorably with the health systems of other countries in terms of responsiveness: shorter wait times, faster access to high tech care, and greater amenities of care.
Q: Is there anything else we should know about this book?
A: This is a book containing 41 chapters you can dip in and out of. It has a varied fare – straight reporting, interviews different folk with different points of view – businessmen, health care agents, doctors, government, a self-interview with the author, and a toast and prayer for President Obama. It is indexed, making it easy for you to explore topics you are interested in. It explains what patient-centered care and consumer-driven care are all about, and it explores why America’s individualistic, entrepreneurial, and innovative cultures make America medicine different – sometimes better, sometimes worse – from health care in other nations. Above all, it emphasizes we are a bottom-up society that thinks for itself and relies on the common sense of its many peoples in different regions of the country with different cultures.