Disease, Diagnoses, and Dollars: Facing the Ever-Expanding Market for Medical Care

ISBN-13: 9781441925435 / Angielski / Miękka / 2011 / 190 str.

Robert M. Kaplan

Opis

Disease, Diagnoses, and Dollars is about the costs of health care and their impact on health. The U.S. health care system is the largest sector in the biggest economy, and the US spends significantly more per capita on health care than any other country, yet it ranks last among comparison nations on the major health indicators. Within the U.S., there is evidence that regions that spend more do not have better outcomes, and some evidence suggests that quality of care is lower in the regions that spend more, not less, on health care. Robert Kaplan takes the controversial position that mass markets have been created for services that may offer little or no benefit to patients. Many of these markets are for preventive medicine, making healthy people a market for expensive pharmaceutical products and tests. These include cancer screening tests and medications to control blood pressure, cholesterol, and glucose. Kaplan forcefully argues that the overuse of medications and tests runs up the costs of health care. As more employers drop health insurance for their employees when costs accelerate, the expanded use of ineffective preventive medicine may have the unintended consequence of increasing the number of uninsured patients, potentially damaging the health of others in the community. The concluding chapters of Disease, Diagnoses, and Dollars offer suggestions for policy makers and for patients. Methods for systematically evaluating the cost-effectiveness of new guidelines are discussed. The final chapter provides practical suggestions to enable patients to share in decisions about treatments or tests that can have uncertain benefits.

Recenzje

From the reviews:

"This book discusses points of tension in the U.S. healthcare system and places the burden on readers to critically think about the paradoxes consumers face. ... The intended audience includes health providers and consumers." (Carole A. Kenner, Doody's Review Service, February, 2009)

"Disease, Diagnoses, and Dollars is an exceptionally practical, carefully argued study of what can be done to control health care costs by improving the approach to medical decision making. Kaplan persuasively demonstrates the practical wisdom he has learned from wide-ranging research and insightful clinical observations. His book challenges the assumptions of patients and physicians. I believe that many of his concrete recommendations can save not only dollars but the health of patients and the satisfaction of physicians in their professional practice." (James F. Bresnahan,  JAMA, Vol 302, No. 3)

Spis treści

Disease, Outcomes, and Money.- The Disease-Reservoir Hypothesis.- Mental Models of Health and Healthcare.- What Is Disease and When Does It Begin?.- Screening for Cancer.- Deciding When Blood Pressure Is Too High.- The Cholesterol Cutoff.- Diabetes, Obesity, and the Metabolic Syndrome.- Cost-Effectiveness and Opportunity Costs.- Shared Medical Decision-Making.- Putting the Pieces Together.

O autorze

Robert M. Kaplan is Professor and Chair of the Department of Health Services at the UCLA School of Public Health. He is also a Professor of Medicine at the UCLA David Geffen School of Medicine. He has been elected president of four different academic societies and has served as editor-in-chief for two major journals. Kaplan is the author or editor of 16 books and more than 400 articles or chapters. In 2005, he was elected to the Institute of Medicine of the National Academies of Science.

Blurb

Disease, Diagnoses, and Dollars

Facing the Ever-Expanding Market for Medical Care

Robert M. Kaplan, UCLA School of Public Health, Los Angeles, CA

Close to 50 Million Uninsured,

Steeply Rising Insurance Premiums,

Employers Cutting Healthcare Benefits . . .

There’s plenty wrong with this picture. In Disease, Diagnoses, and Dollars, public health expert Robert Kaplan takes America’s healthcare industry to task and challenges readers to examine their own roles in it.

Provocative, timely, and comprehensively researched, this book analyzes the current healthcare crisis in terms of medical culture, economics, and advertising. The findings reveal a system fraught with conflicts—contradictory healthcare policies, providers who over-test and over-prescribe, patients with unrealistic demands fueled by the media—and throughout, an absence of accountability. Much of preventive medicine, Kaplan persuasively argues, comes down to the selling of expensive pills and procedures that drive up costs while subjecting the population to unneeded risks and complications. And the end result, he argues, is excess care for many people, and a dearth of care for many more.

Kaplan’s informed, practical, and constructive approach makes Disease, Diagnoses, and Dollars a "must-read" volume for policymakers and professionals in public health and healthcare, and for business owners as well as ordinary citizens and consumers concerned with the viability of healthcare in America.