Rowman & Littlefield Publishers
Trim: 6 x 9
978-0-7425-5830-4 • Paperback • August 2008 • $19.95 • (£14.99)
978-0-7425-6591-3 • eBook • March 2007 • $19.00 • (£14.99)
Arthur Garson, Jr., MD, MPH, is Executive Vice President and Provost of the University of Virginia and previously was dean of the University's School of Medicine. He is a member of the National Academics Institute of Medicine. He has served as president of the American College of Cardiology and was appointed by Health and Human Services Secretary Tommy Thompson to chair the National Advisory Council for the Agency for Healthcare Research and Quality. He continues to practice medicine, caring for children with heart disease. Carolyn L. Engelhard, MPA, is assistant professor of medical education and a health policy analyst in the Department of Public Health Sciences at the University of Virginia School of Medicine. In addition, she directs the Master of Science program in clinical research and provides technical and consultative services to state health and Medicaid agencies.
Chapter 1 Introduction
Part 2 I. Our Country and the World
Chapter 3 1. American Medical Care Is Second-Rate Compared to Other Countries
Chapter 4 2. American Health Care Is the Most Expensive in the World
Part 5 II. Cost: The Expensive Care Myths
Chapter 6 3. America Wastes One-Half of its Medical Care Dollars
Chapter 7 4. Most Medical Care Dollars Are Spent in the Last Six Months of Life
Chapter 8 5. Better Quality Saves Money
Chapter 9 6. Preventive Care Saves Money
Chapter 10 7. America Will Not Ration Health Care
Part 11 III. Quality: The Good Care Myths
Chapter 12 8. Science Drives Most Medical Decisions
Chapter 13 9. High Quality Care Cannot Be Defined
Chapter 14 10. Consumers Can Make the Best Decisions about Their Medical Care
Chapter 15 11. Fewer Doctors Will Be Needed As Medicine Changes
Chapter 16 12. The Current Malpractice System Helps Patients
Chapter 17 13. Managing Care Is Evil
Part 18 IV. Coverage: The Insurance, Underinsurance, and Uninsurance Myths
Chapter 19 14. In America, There Is a "Safety Net" of Government Programs Providing Health Care for the Poor
Chapter 20 15. People Who Work Can Afford Health Insurance
Chapter 21 16. Provision of Health Insurance for Employees Has Always Been the Employer's Responsibility, and Will Continue That Way
Chapter 22 17. The Uninsured Get the Care They Need in Emergency Rooms
Chapter 23 18. No Additional Funding Is Needed to Cover the Uninsured; the Money is Available in the System
Part 24 V. The Future
Chapter 25 19. All Other Countries Provide Health Care Coverage for Everyone; We Should Be No Different
Chapter 26 20. Major Change in the American Health Care System is Impossible
Before one can make a cure, one has to get the right diagnosis. This book is an outstanding addition to the debate on fixing American healthcare with its thoughtful exposure of myths with well researched reality. It is a must read for the public, payers, physicians and policy makers.
— J. James Rohack M.D, director, Scott and White Center for Healthcare Policy
A realistic perspective on our health care system that is highly informative yet refreshingly optimistic when it comes to needed change.
— Steven A. Wartman M.D., PhD, president and chief executive officer, Association of Academic Health Centers
How exhilarating it is to read a book on health care policy that dispels delusions—that prevention always saves money, that we can stop growth of health care spending without rationing, that doctors always know what they are doing, that the uninsured and poor always get at least emergency care, and the biggest delusion of all—that there is no politically achievable way to extend health insurance coverage to all Americans.
— Henry J. Aaron, The Brookings Institution
I could not put this book down! Every American should read it!
— Wayne Turnage, Deputy Chief of Staff for Virginia Governor Tim Kaine
Health care now accounts for one-sixth of the entire US economy, yet it is misunderstood by almost everyone. By challenging common myths about health care, Garson and Engelhard artfully help readers of all levels of expertise gain a far better appreciation of the strengths as well as the problems of our health care system.
— Stuart M. Butler, vice president for domestic policy, The Heritage Foundation
A much-needed dose of realism, this state-of-the-policy report should be required reading for anyone weighing in on the debate over health-care reform, especially students of health policy. Dean Garson and policy analyst Engelhard show how both defenders and opponents of the current American health-care system rely on false truisms and lazy thinking, such as the idea that most health-care dollars are spent in the last six months of life, or that consumer choice automatically improves care. Members of Congress cling to the hope that quality improvement programs or more preventive care will save enough money to bail out Medicare and other programs, but Garson and Engelhard expose the flaws in these arguments. Thanks largely to its well-thought-out structure, this book makes a surprisingly quick read; in the introduction, for example, the authors' myth vs. reality chapter descriptions make for easy browsing and reference. The sheer number of misconceptions exposed and the seemingly intractable dysfunction of the health-care system as a whole result in a sobering tour, but the final chapter proposes some sound, if occasionally controversial, solutions. Though more general readers may balk at some tedious hair-splitting, this title successfully flushes the plaque from the hardened arteries of the country's health-care dialogue.
— Publishers Weekly
Health Care Half-Truths is a great resource for the public and for policy makers as they tackle what has become a mired behemoth—healthcare in America. Whether trying to get in to a doctor, affording the charges, or understanding the systems, healthcare often overwhelms us as consumers as well as those who seek to put forward sound policy. If you want to understand how we got where we are or if you want to start making changes, Health Care Half-Truths is a valuable place to start.
— Jane Woods, former Secretary of Health and Human Resources, Commonwealth of Virginia
Garson and Engelhard make a fundamental point that all policymakers, business leaders, and healthcare stakeholders must hear: change is possible. Despite all the myths, half truths, and real-world problems, we can build a 21st century intelligent health system that saves lives and saves money for every American. The authors pull no punches, and by doing so make an important and lasting contribution.
— Newt Gingrich
Health Care Half-Truths is a fascinating book dealing with one of the most important and seemingly intractable issues of our time in the United States: equitable and high quality health care. . . . The book is highly recommended to students and teachers as well as policy makers, health care workers and anyone interested in a deeper understanding of today's health care dilemma.
— David J. Skorton, M.D., President, Cornell University
Health Care Half-Truths contributes significantly to the debate over health reform by correcting the biggest myths about health care in the United States. Dr. Garson and Ms. Engehard answer the false perception that the U.S. offers some of the worst health care in the developed world and even that preventive care always saves money, for example. By starting with a clearer diagnosis of the problems in the health sector, they believe policymakers will be able to build on its strengths and correct its weaknesses. The book gives policymakers a big dose of reality to guide their decisions.
— Grace-Marie Turner, President, Galen Institute
Health Care Half-Truths is a provocative and important book—easy to digest and stimulating to the mind! By challenging the conventional wisdom, it forces all of us to rethink what we know about American health care.
— Karen Davis, President, Commonwealth Fund
Garson and Engelhard...offer an excellent, well-documented text...the book offers extensive up-to-date references and resources separate from the straightforward text. Summing Up: Recommended. All Levels.
— J.E. Thompson, Western Michigan University; Choice Reviews
Take this true-false test and read the book to find the answers!
American medical care is second-rate compared to other countries: T/F
America wastes one-half of its medical care dollars: T/F
Most medical care dollars are spent in the last 6 months oflife: T/F
Preventive care saves money: T/F
Consumers are able to make the best decisions about their medical care: T/F
There is a “safety net” of government programs providing health care for the poor: T/F
Major change in the American health care system is impossible: T/F