Prescriptions for Health Reform

Dr. Norton Hadler, author of “Worried Sick” claims that today in the United States, the practice of medicine is “built on a bunch of sophisms” with “very little to do with the care of the patient.” His solution? Cut way back on procedures and interventions and act only when data suggest the patient will benefit.

Two years ago, David Goldhill's father died of a hospital-borne infection. Goldhill wrote about the experience for the Sept. 2009 issue of The Atlantic. In this interview, he talks about what he learned: "The reality is we as individuals make all our major health care decisions. And yet we lack the type of information, we lack the type of relationship with providers, that we have in any other service we acquire and hire. ... [T]his is an industry that almost totally lacks publishable data on results, is completely non-transparent when it comes to pricing, and rarely has the type of relationship with patients that almost all other consumer-facing industries have."

George Halvorson talks about the "perverse economic incentives" at work in health care today as well as the need for more connection between providers and patients, and more coordination among caregivers. The chairman and chief executive officer of Kaiser Foundation Health Plan, Inc. and Kaiser Foundation Hospitals, Halvorson is also an author of several books on health care, the most recent of which is "Health Care Will Not Reform Itself."

Journalist T.R. Reid talks about his global quest for health care documented in his new book "The Healing of America." Reid compared plans, in part, by having local doctors treat his bad shoulder. In the end, he says, "I came home with more movement and less pain in my shoulder, so that was a win, and I came home convinced that we could cover everybody at reasonable cost. I know we can do it because all the other countries like us already do it."

Peter Conrad warns against the costs and consequences of over-medicalization, which he defines as the creation of “diagnoses for particular kinds of human problems."

Dan Perrin sees Health Savings Accounts as one way to help insure the 47 million Americans now without health insurance. But he predicts that national health reform will ultimately be a victim of political mishandling: “God bless the health care community, but they are so driven by their policy desires that they ignore this political stuff and every time, it beats them. Every time.”

C. Rocky White, M.D. explains how he's come to embrace single-payer health reform, despite his politically-conservative background, and why he believes that economic incentives to make money are distorting the nation's health care system.

Phillip Longman asserts that the Veteran’s Administration is providing the the safest, most effective, and most scientifically-driven healthcare in the United States today in large part because of the lifelong relationship the VA has with its patients and its forerunner status in the field of electronic medical records.

Julie Salamon talks about the business pressures on hospitals and how they impact the delivery of care, the complexity of running a 700-bed facility, and the need for community-based services.

Jonathan Cohn talks about how the next person to be hit with catastrophic medical bills could be you. He also comments on unresolved issues and compromises that must be reached before the passage of national health care reform. Finally, he examines how Massachusetts’s health care reform law can serve as a national model.

Arnold Relman, M.D. talks about the "medical industrial complex" and how the commercialization of medicine has impacted doctors and the delivery of care in the United States, as well as the challenges Massachusetts faces in sustaining health care reform.

Regina Herzlinger talks about the need for transparency in provider outcomes, how Switzerland’s health care system models a framework for building a consumer-driven system in the U.S., and how integrated centers focused on the treatment of chronic conditions reduce health care costs.

Melody Petersen, author of Our Daily Meds: How the Pharmaceutical Companies Transformed Themselves Into Slick Marketing Machines and Hooked the Nation on Prescription Drugs talks about deceptive marketing practices by pharmaceutical companies, the need for greater federal oversight of drug companies, and offers advice for consumers when talking about prescription drugs with their doctors.

Shannon Brownlee, author of Overtreated: Why Too Much Medicine is Making Americans Sicker and Poorer talks about prospects for national health reform.

Charles Kenney, author of The Best Practice: How the New Quality Movement is Transforming Medicine talks about quality, affordability, and cost containment in health care.