Market-Driven Healthcare: Who Wins, Who Loses in the Transformation of America's Largest Service Industry
Author: Regina E. Herzlinger
List Price: $19.00
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ISBN: 0738201367
Publisher: Perseus Book Group (May, 1999)
Sales Rank: 16,895
Average Customer Rating: 3.3 out of 5
Customer Reviews
Rating: 3 out of 5
Fatally flawed vision of focused health factories
Professor Herzlinger offers a fatally flawed vision of health reform, based on a persuasive premise: the absence of focused factories in the US health care system needlessly diminishes the quality of care and increases its cost. She thus concludes that not only is withholding focused factories uneconomical but also unethical.Agianst this, she seems to be unaware of the ethical conflicts of interests created in the system she envisions, which led Dr Linda Peeno, working as an HMO executive to conclude that she felt part of some psychology experiment whose design was to see how quickly those of us in the health profession abandoned our humanity.
The lessons for the health profession and the risks posed by focused factories are clear: given our endangered integrity, we have an ethical obligation to end the strained silence while our professional integrity is rationed away. A Jerome Kassirer noted, to capitulate to an ethic of the group, I would add like a focused factory manager, rather than the individual patient, allowing market forces to distort our ethical standards will inevitably lead to the suffering of our patients and our profession. Ultimately if we adopt Herzlinger's vision for health reform, we risk becoming the economic agents of focused factories.
George Halasz Australia
Rating: 4 out of 5
So she's no Tolstoy, but the ideas are great.
No one will accuse Ms. Herzlinger of being a great writer, but her conversational style is easy to read and she does have some good ideas for how the healthcare industry should be. Ideas that still haven't been implemented even now, 8 years after it was written. She does make a fairly convincing argument for how focused factories could reduce costs. In addition, suggestions that everybody should have health insurance, that healthcare providers should not be insulated from market forces, that consumers are the ones with the real power to stop the soaring healthcare costs, and that they'll only curtail spending when given incentive to do so are good points that can't be made often enough. Points that seem even more relevant today given the continued increase in healthcare costs, the inability of the HMO system to manage them, and the spiraling problem the growing uninsured population is creating (the more uninsured people there are, the more insurance costs, which increases the number of uninsured, etc.). She has good ideas, I think it's time people listened. It's of vital importance that the healthcare system incorporate what's great about America, what has made America a leader in every other industry: innovation and sensibly regulated free markets. Ms. Herzlinger gives us a good way to get it done.I also have to ask if some of the other reviewers actually read the book. The author gives a pretty good analysis of how focused factories would reduce costs, using that 20% of the people produce 80% of the costs as a cornerstone of her argument. Also, she cites physicians' inability to deal with market forces as a cause of the problem and gives suggestions for how to deal with it.
Rating: 2 out of 5
There is no "market" in American medical care, period.
Market forces cannot solve the medical crisis. No market exists. Knowledge of what is sold is inequivalent: if patients knew the difference between colonoscopy and colposcopy, they would not know the fair market value of either procedure. Unlike buying a car, where the dealer knows you can walk off, patients cannot negotiate, and can't determine the quantity of medical services needed. Eyeglasses constitute a misleading example. Physicians are the principal drivers of all expenditure on medical care. Without a medical license, nothing can be ordered or prescribed. This fact must be faced squarely: the supplier of services regulates the level of demand for medical services. Annual outlays have now reached $1.6 trillion with no end in sight to the physician-driven escalation in expenditures. This is not COST inflation, but relentless EXPENDITURE INCREASE driven chiefly by an oversupply of medical doctors. If this system is ever to be fixed, these stubborn realities must be faced. This author evidently has no clue that there is not a "market" operating in the world of medical care delivery, thus her analysis is unhelpful. Similar Products
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