The Truth About Health Care

Mechanic, David
September 2009
Truth About Health Care - Business Book Summaries;2009, Vol. 1 Issue 1, p1
Book Summary
Book Summary
Every industrialized nation except the United States provides basic health care for all of its citizens. According to one statistic, 46 million Americans went without insurance for the entire 2003-2004 period and an additional 37 million went without it for part of that time. In his book The Truth About Health Care, Mechanic makes a broad examination of the many challenges in providing adequate health care and the factors hindering large-scale reform. Mechanic sees wholesale change as sorely needed in health care but doubts whether it is possible anytime in the near future. Instead, he advocates efforts to make piecemeal changes wherever possible. For him, hope glimmers more in the seemingly small technical decisions made under the political radar than in big reform ideas. The sectors of health care badly in need of reform include care for chronic and mental illness, end-of-life care, and primary care. The issue of public health is also a concern. Much less money is spent on prevention and health promotion at the community level than on curing specific diseases. Taking such a narrow approach means that most diseases and their cultural and environmental determinants will be overlooked. For across-the-board improvements in care, Mechanic strongly urges the thoughtful use of information technology. IT can enhance access to and maintenance of patient records, the identification of high-risk patients, and the management of chronic illness. It can also enable the application of evidence-based standards in deciding among treatment and prescription-drug options. The costs of providing medical care have surged in the past decades and continue to swell, making our health care predicament an enormous one. Medical expenses now constitute 16 percent of our gross national product. Evidence-based practice is the cornerstone of a more functional and efficient kind of health care system and it can save the nation a significant amount in health care costs by promoting more...


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