Reinventing American Healthcare Summary

Reinventing American Healthcare This book begins with the introduction of real people who have had to deal with the complex, headache-inducing healthcare system of the United States. Next, the author, Ezekiel Emanuel, begins Part I of the book with a brief history explaining how the current state of healthcare came to be. Physicians used to have minimal education and used hospitals for training. Health insurance didn’t come about until around 1929. Most Americans get their healthcare from their employers because it was, and still is, a tax-exempt way for employers to entice people to work for them. Emanuel continues by explaining the entities, private and public, that pay for most of an American’s healthcare and how much they cost. The next

The first chapter of this part detail the debacle of the healthcare.gov implementation and potential problems in the future execution of the ACA. The next chapter’s goal is to explain how we can measure the success of the ACA’s implementation. To do so, Emanuel suggests using his four healthcare reform dashboards, which detail his goals for coverage expansion, cost control, healthcare quality, and overall health status and when they should be achieved. The next chapter lists 4 extra reforms to build on the ACA that Emanuel believes can be implemented in a timely manner and have a significant effect. These include raising cigarette taxes, securing and improving the ACA’s competitive bidding program, simplifying medical administration, and ousting the fee-for-service system that plagues the healthcare industry. The final chapter of part III lists 6 big predictions for the future based on current trends: the end of our current medical insurance system, special care for the chronically and mentally ill, expansion of digital healthcare and the closure of over 1000 hospitals, the end of employer-based health insurance, no more health care inflation, and a significant restructuring of medical education. Not only are these predictions bold, Emanuel expects them all to occur by 2025. Emanuel ends Reinventing American Healthcare by asserting that, while enacting the ACA significantly

He points out that, despite very similar characteristics, the El Paso County spends much less money on healthcare than McAllen does. Gawande then points out that, while the most of the city is poor, McAllen’s medical facilities are on par with those at Harvard or Stanford. Despite its advanced facilities and equipment, the quality of McAllen’s healthcare is still worse than that of El Paso. Gawande found the first clue to the mystery during a dinner with some of McAllen’s physicians. They explained to him that, nowadays, doctors of McAllen will not hesitate to conduct unnecessary procedures, including surgery. Gawande explains that physicians will provide unnecessary care because they know they’ll be making extra money. After looking at the data, he concluded that “The primary cause of McAllen’s extreme costs was, very simply, the across-the-board overuse of medicine.” However, this excessive use of medical procedures, particularly surgeries, have actually resulted in worse health care outcomes in these areas. These doctors will be less likely to provide lower priced and more successful medicine, but instead will provide more costly procedures with potentially worse results. The reason for the unusually high medical costs in McAllen is not the private insurance providers, nor is it Medicare or