Shannon Brownlee

Conglomeration of thoughts:

Perhaps socialized medicine, not "Medicare for all," but medicine, care, insurance strictly regulated might be the answer. Her arguments for the VA system seem to be solid. But they, the VA, do seem to have some drawbacks.

This book was published before Obamacare/ACA was created, put into being, etc. I wonder what, if anything, the writer would change with that law in place.

If the problems with American Healthcare were visualized, it would be as follows:
Physicians, Insurance, Patients, Hospitals, Laws & Lawyers, Pharmaceutical Companies... all pointing fingers at each other but, in reality, all responsible for a portion of the issue (and some of them very well-meaning).

Intermountain Healthcare was touted as one of the better companies/hospitals. If that is true either a) something has changed in the last eight or so years or b) other hospitals are pretty terrible.… (meer)

Shannon Brownlee knows why healthcare costs so much: poor top-down public policy that provides all the wrong incentives to everyone involved in dispensing it. She also knows the solution: top-down public policy that will force everyone to do the right thing. She gives great examples of over-treatment: fancy equipment and tests that really don’t help long-term survival rates, expensive procedures that upon closer examination don’t work, and of course the relentless pursuit of profit among Big Pharma and other Evil Capitalists. She promotes as a model healthcare system, the Veterans Administration, which scored well on all the metrics she promoted when this book was written (2007) but of course was later turned upside down when it emerged that the top officials were lying.

This is an example of a book that does not withstand the test of time. Sure, as a lesson for what happens when top-down policy makers run an entire industry like healthcare, this is an sobering case study, but don’t look here hoping for creative solutions. Brownlee’s only solution seems to be “more of the same, only be smarter about it.”… (meer)