||Cover; Half Title; Title Page; Copyright Page; Table of Contents; Foreword; Preface; Author; SECTION I: INDUSTRY DYSFUNCTION: ITS ROOT CAUSES AND EFFECTS; 1: It's Not the Future We Used to Have; The Old Future; The Curves of Health Care; The Root Causes of Industry Dysfunction; The Economic Human and the Next Curve; Fast Forward: A New Future; This Book: A Look Ahead; References; 2: Health Care's Perfect Storm; The Gathering Forces; What's Wrong with This Picture?; Costs on an Upward Trajectory; Heading toward a Spending Ceiling; Is Rationing the Default Scenario?; References
||3: What Happened to Health Insurance?A Perfectly Dysfunctional Model; Affordable Access: Still No Fix; Mandates Mean Fewer Products, Higher Prices; Employer Health Plans: Not What They're Cracked Up to Be; Medicare Trouble Ahead; Medicaid Also Facing an Uncertain Future; One Size Doesn't Fit All; References; 4: Follow the Money: A Broken Payment Model; Why Not "Food Insurance?"; Fee-for-Service an Incentive for Utilization; Impact on Care Coordination; A Recipe for Waste, Fraud, and Abuse; Moving toward Value; Problems Measuring Value; References; 5: Silos, Everywhere
||Automobiles Get Pretty Good Health Care; Where's the "System" in Health Care?; The Problems of Service Fragmentation; Information Silos: Part of the Problem; Geographic Silos, Too; Population Health: More Teamwork Needed; Silo Culture Part of the Industry's DNA; References; 6: The Real Costs of Regulation; The Perils of Regulatory Overreach; The Computer Will See You Now; The Price of Regulating Prices; Certificate of Need a CON Job; More Regulation, Less Innovation; Frozen in Time; Tort Reform, a Critical Need; The Real Costs of Regulation; References; 7: Where's the Competition?
||Competition anValue morere Government, Less Competition; Independent Physicians: An Endangered Species; Eroding Competition in the Insurance Market; Conflicting Market Signals; Narrow Networks, Narrower Choices; Consumers Caught in the Middle; References; 8: Why Government Health Care Isn't the Answer; "It's the Government: They Know Best ... "; Medicare for None?; Single Payer Means Higher Costs; Rationing Is an Inevitable Outcome; Impacts on Education, Research, and Innovation; Administrative Costs Aren't Necessarily Lower; Single Payer Very Popular-Until People Understand What It Is
||Americans Don't Do Socialism VerWell referenceses; 9: Market Disruptors and Transformers; Big Data and a New World of Precision Medicine; The Patient Is in; A Fusion of Segments; Employers/Health Care; Big Pharma/Insurance/Health Care; Providers/Health Plans; Providers/Suppliers; Is the Community Hospital Becoming Obsolete?; Collective Consciousness and an Empowered Market; References; SECTION II: HEALTH CARE IN THE NEXT CURVE: A ROADMAP TO INDUSTRY TRANSFORMATION; 10: Destinations of the Next Curve; Access, Choice, and Value; Access; Choice; Value; A Roadmap to Industry Transformation
||Healthcare in the U.S. is a critical juncture. We face a sharp upward rise in the number of people with chronic diseases and disabilities. As demands on our current health system grow, so will costs. But as a society we are approaching the upper limit of how much we are willing (or able) to spend on health care. Health care policy makers know this. That is why major health reform measures are focused on population health and value-based care. These are the so-called second curve objectives. But these initiatives are doomed to failure. We are asking a system to do things that it was not designed to do. In fact, we don't have a health care "system" as such. We have a parts bin of disconnected silos. Fragmented delivery systems. Specialized caregivers. Professional groups. Trade associations. All with distinct cultures. Each with their own motivations and agendas. Our payer and regulatory structures have evolved over the decades in response to political and policy initiatives. However well intentioned (or not), these structures defy logic. They reward and reinforce counter-productive industry behaviors. They pose formidable roadblocks to achieving needed changes. Current reform initiatives are an implicit recognition that our health model is flawed. The attitude seems to be, "Yes, we know the overall health system is a problem, but we can make failure less severe if we implement these measures." We are at a critical juncture. We can continue to place additional demands on an industry model that has outlived its functional utility. Or we can take more of a clean slate approach and move toward a model that is in keeping with today's needs. The outlook is not good if we stay on the current curve. The demands on resources will continue their upward trajectory. The default scenario will be one of rationing and less to invest in new cures and new technologies. The good news is that we are within sight of a future state of health care that can really work. In this future state, we have gotten rid of the artificial barriers to effective and efficient patient care. Physicians and other health professionals work in a coordinated, inter-disciplinary fashion. They have accountability for the whole care cycle. Caregivers have both the flexibility and encouragement to innovate and come up with optimal delivery approaches. And because they are in a risk-reward relationship with payers, they have the incentives to provide true value. Patients feel intimately connected to a system that is focused on their specific needs. The key to this future state is good old-fashioned market discipline. Other delivery models must either improve or get out of the way. The market will demand cost-efficiencies and won't tolerate waste. Much of our regulatory structure will be rendered unnecessary. There will be not rewards for poor performance. This book takes a unique macro-level perspective of clinical, economic, and regulatory problems and possible solutions. It takes an objective and something scathing look at current industry structure: a silo-driven culture and entrenchment that is driven by self-interest; as well as the complicity of government in preserving the status quo through regulations, licensure, payment systems, etc.
|General note||11: First, the Safety Nets|
|Bibliography note||Includes bibliographical references and index.|
|Source of description||Print version record.|
|Issued in other form||Print version: Abendshien, John. Health Care in the Next Curve : Transforming a Dysfunctional Industry. Milton : Productivity Press, ©2018 9781138626546|
|ISBN||9781351855228 (PDF ebook)|
|ISBN||9781351855204 (Mobipocket ebook)|
|ISBN||1351855204 (Mobipocket ebook)|
|Stock number||9781351855211 Ingram Content Group|