Friday, December 16, 2016

Review: The Healthcare Cure

This is a book review of The Healthcare Cure: How Sharing Information Can Make the System Work Better by Jeff Margolis. I was not compensated in any way for this review.

If you've ever wanted to understand how the healthcare system works, systems thinking, and more, this is a book you need to pickup. The first part of the book goes over current-state and the problems we encounter in healthcare.

It's also a great primer on the economics of healthcare, something that people tend to pay big money to better understand.

Terms are defined so that even some of the most complicated parts of healthcare are understandable. Comparisons to the auto industry, parables, and more are made. 

In chapter 5, the author goes over the perspectives of all involved in healthcare - consumers, providers, employers, brokers. One could argue that this doesn't necessarily touch everyone in healthcare and they'd be right, but this works for the author's purpose. 

After going over key terms and explaining the current-state of the system, the author begins to talk about what he sees as the cure: Integrated Healthcare Management (IHM). One reassurance Margolis gives us that we need right now is that IHM will be achievable even if the Patient Protection and Affordable Care Act bites the dust. 

IHM helps to further what we patients want - better decision-making opportunities supported by our healthcare teams, eliminating unneeded variation in our care, and making the whole system run more smoothly.

I can tell you this is what providers and administrators want, too. The system is so broken and no one is happy with it. 

What is IHM?

It's a form of healthcare that helps to promote better health and quality of care over more care in general. By helping to eliminate the silos within the system, we will be able to better participate in our own care. With the silos gone, it also helps us access our data! And, ideally for Margolis, healthcare plans would be customizable according to what we need.

I'm not sure about that last part. Sure, it would be nice for me to not have to pay for prenatal coverage knowing that I'll probably not have kids, but what happens if I do get pregnant then? Insurance plans generally don't let you change quickly enough to get the right coverage. Plus, frankly, I don't mind paying for that coverage because I know it helps cover those who do utilize those services.

Really, though, IHM helps us all to focus on the same thing - value. Right now, each piece is focused on different things. 

I fear, though, that with the new administration coming in, this won't be anywhere near the focus for our healthcare system... especially because it will eliminate overhead and unneeded spending.

Some of the personal responsibility touched on in the last chapter was... unnerving, mostly because it was ableist in nature. Yes, taking responsibility for our day-to-day health and the like will lead to better healthcare outcomes, etc, but that leaves out those of us who can't get in front of our health fun and the like. 

Sure, it helps for us to take care of ourselves, too, but we have to do that to stay alive - not for better outcomes.

All in all, I found this book to be an informative look at what is currently ailing our healthcare system and a potential for a cure. Like many other purported cures, this needs much more research and tweaking.

Favorite quotes:

"Not only are we humans unable to access our medical records when needed, there is also a tremendous degree of variation in the treatment we receive, even among people with the same conditions and similar health backgrounds. Treatment of humans... is not consistently based on 'best practices' (the treatment that research has shown to be most effective for a particular condition given a patient's age, overall health and family history of disease). Studies shoe that although healthcare experts have researched and documented best practices for a wide variety of medical conditions, patients often receive treatment that is different from what is proven to be most effective." (38)

"Hoping that other people are going to solve the healthcare crisis for us, either at a national, or individual level, is not a plan." (195)






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