Not everyone is enamored of Health Savings Accounts (HSAs) or patient power. There are even people who dislike HSAs almost as much as they dislike the syllogism. Alas, they are legion. We are surrounded by them. Were righteousness and virtue not on our side, we would have been vanquished long ago.

Many of the complaints of HSA critics are forcefully argued in a new book entitled Health Care at Risk – which I take to be the Freudian counterpart to our own book titled, Lives at Risk. Continue reading »

Harvard Business School Professor Regina Herzlinger has written a must-read book, "Who Killed Health Care?". It is written in the style of a murder mystery. The puzzle to be solved: Who killed Jack Morgan, (a patient who dies while awaiting a kidney transplant)? Like Murder on the Orient Express, there is not one killer here but many: health insurance companies, hospitals, employers, the federal government and even academics.

Jack Morgan is a composite figure, based on the experience of 112 people who needlessly died while waiting for a kidney transplant. They were all insured by California-based Kaiser Permante. Of those who died while waiting, 25 had a perfect match. Continue reading »

One of the most fascinating books I have ever read in health economics is The Painful Prescription, an analysis of rationing in the British National Health Service (NHS) by Henry Aaron and Bill Schwartz.  The Brookings Institution has now published an update, Can We Say No?, and it's every bit as rewarding as the original.

Britain spends less than half of what the U.S. spends on health care on a per capita basis.  (The British also get less.  For more than a half century, the NHS has promised health care free of charge to all its citizens.  Yet upward of a million people are on waiting lists for care.  Unable to get what they need from the public system, many pay out of pocket in the private sector, which provides one out of every five surgeries and almost one-third of all hip operations.  Although equality of access to care has always been an overriding goal, gaps in mortality rates among British social classes have been widening over the past three decades. Continue reading »

"Redefining Health Care" by Michael Porter and Elizabeth Olmsted Teisberg (P&T) is a must read for anyone interested in health policy. Granted, it's a bit daunting at 500 pages, but here's a hint: the first 100 pages or so gives you the best return on your reading time.

Reviewers from left to right (Reinhardt, Enthoven, Wilensky, Robinson, Maynard, etc) have uniformly panned the book at the Health Affairs website.

There are some things not to like. My own complaints include: giving short shrift to HSAs, failing to give Regi Hertzlinger her due, and taking a naïve approach to some public policies. Continue reading »