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Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System

By Phil Bredesen
Book Details
  • Author: Phil Bredesen
  • Binding: Hardcover
  • Publisher: Atlantic Monthly Press
  • Published: 2010-10-05
  • Edition: First Edition, First Printing
"American health care, which has come so far in the last century, seems now to have lost its way. Its productivity has stagnated, with its growth in cost far outstripping its gain in effectiveness. Its blueprint is obsolete: a design for acute illness when chronic illness increasingly absorbs our resources and shortens our lives. Entrenched interests paralyze it just when it most needs to change and adapt."

"Our `reform' wasn't transformational, nor was it particularly courageous. The planets were aligned: for a moment, Americans were attentive, were ready to listen and to try new things. But neither the president nor the Congress---and I include both parties here---were willing to talk plainly and honestly to the American people. They were unwilling to tell us things we didn't want to hear or to call on us to do anything hard."

"America is on a dangerous collision course with fiscal reality that we can't ignore much longer. To remind us: in 2008 our Medicare program alone had unfunded liabilities of around $37 trillion. To put that in perspective, that represents a current obligation of about $280,000 for every full-time worker in America."

"Our high cost of health care, and its continued high rate of growth, is not the result of technology, or administrative overhead, or chronic disease, or malpractice suits, or the lack of information systems, or transparency. It's the direct and inevitable result of our having systematically removed the economic tension between buyer and seller that makes efficient markets work."

"In this important new look at a topic of urgent concern to the country, Phil Bredesen does something unique: he brings together the perspectives of a businessman, a politician, and an historian to tell the story of health care in America. Told with skill and grace, Fresh Medicine explains how we got where we are, and what we have to do going forward. Bredesen has given all of us a great gift"---Jon Meacham, Author of American Lion: Andrew Jackson in the White House

This spring, after Congress passed sweeping legislation to reform our nation's health care system, the editorial board of the New York Times wrote: "just as Social Security grew from a modest start in 1935 to become a bedrock of the nation's retirement system, this is a start on health care reform, not the end....The process has finally begun." One of the key voices in that process will be Philip Bredesen, the governor of Tennessee. Bredesen brings a unique perspective to this debate because of his experience in both the public and private sectors, having served as governor and, before that, having built a successful, multi-million dollar health care company that was listed on the NYSE. In Fresh Medicine---the first book to address this reform---Bredesen delivers a concise, intelligent analysis of what the reform is, how it is flawed, and why we have to fix it

Bredesen begins by exploring the problems with the new reform. He argues that Congress and the Obama administration have added over thirty million people into an obsolete broken system and have done little to address the underlying problems: its finances are unsustainable and threaten our nation's future. Rather than providing real solutions, the reform simply added new layers of bureaucracy and complexity to this baroque system.

Bredesen then looks back and explains how the system has evolved over the past century from the local doctor making house calls to today's sprawling insurance model. American health care, he asserts, needs to be reset on a new foundation. Without dealing with the tough problems---cost, sustainability, and quality---true reform will be elusive. Basic health care should be a universal right for all citizens. Americans simply pay too much for health care, and so costs must be reduced by reintroducing the economic tension between buyers and sellers that makes the marketplace work. To accomplish that, Bredesen argues we need to place a formal approach to quality of care---defining practice standards and auditing compliance---in a central position in our health care system.

In Fresh Medicine, Bredesen harnesses thirty years of experience to offer a bold, nonpartisan, and definitive take on what is wrong with health care in America, how it got there, and how we can fix it.

"Phil Bredesen knows the American health care system inside and out. He knows both the theory and, more importantly, how things really work. His perspective is unique and wise; if you're interested in health reform, you'd do well to read and consider what he has to say"---Bill Frist, M. D, Former Senate Majority Leader

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