Congratulations | Redefining Health Care: Creating Value-Based Competition on Results

How sick is US Healthcare | Redefining Health Care: Creating Value-Based Competition on Results | Michael E. Porter, Elizabeth Olmsted Teisberg

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	• Redefining Health Care: Creating Value-Based Competition on Results Michael E. Porter, Elizabeth Olmsted Teisberg Harvard Business Press, 2006 - 506 pages average customer review:based on 28 reviews view larger image
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highly recommended

Valuable addition to the Health Care debate

As the son of a physician, I have a fondness for all things medical... except the current state of our American health care system!

Michael Porter and Elizabeth Treisberg have done the nation an oustanding service to analyze the current mess and propose a meaningful way forward, based on the successful strategic principles of competition. Rather than think about "procedures", "access", and "costs", they call us to think bigger about "patient-centric", "care cycles", and "outcomes based". As the new Obama administration prepares to undertake what many think will be a massive overhaul of the system, all health care consumers--which is all our us!--should read this book to be informed participants in the coming Great National Healthcare Debate.

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Congratulations

This a great book for physicians that likes strategic administration. Porter and Teisberg provides a major contribuition for the health care.This book will enable dramatic improvement in the efficacy and quality of patient care in the USA and other countries.

How sick is US Healthcare

Interesting view on the actual US health care and a challenging way to solve the mailaise

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Excellent analysis with some weak points

This book has received probably disproportionate attention due to Prof. Porter's notoriety as a strategic thinking theorist. There are better overall books on health care policy available. In particular I recommend the Bodenheimer/Grumbach books, one on healthcare policy and one on primary care, Dr. Arnold Relman's book, A Second Opinion, Strained Mercy, an outstanding and thorough analysis of healthcare economics with particular regard to Canada's healthcare system and Pricing the Priceless a more technically-oriented economic analysis by Prof. Joseph Newhouse, among other books.

I find the analysis of the USA healthcare system by Profs. Porter and Teisberg to generally be excellent, although I find it wanting in regard to their disparagement of a single-payer/single-insurer system and to their description and analysis of healthcare systems outside the USA. From my perspective private health plans play only a net negative role in the system. The authors' analysis of how the health insurance market works is quite good. However their recommendation that a system of private insurers should persist is refuted by their own analysis! A single payer/insurer system will not cure many problems of the USA system, as they clearly point out, but it does remove the inherently dysfunctional characteristics of private insurance, not least of which is its failure to meet the needs of the uninsured - a very large number - and its inherent propensity to exclude the very people who need coverage and care. The authors rightly point out that mandatory health insurance along with risk-pooling among insurers to spread the costs of those insured individuals who generate the highest costs is a "solution" to the current non-functioning system, but the same result, at lower cost and with much greater simplicity, can be achieved through a single payer/insurer.

The other key aspect of healthcare - how it is delivered - is ultimately more important than the financing/insurance side. The authors provide excellent analysis and recommendations in this regard. They correctly address the aspects of the healthcare market that prevent its functioning as a "competitive" market, specifically the abysmal lack of patient information on prices for services, on outcomes of actions by providers, comparative statistics on provider performance and similar. They also provide an interesting report by the Cleveland Clinic on outcomes, i.e. results, of the Clinic's heart surgery activity. They appropriately use this as an example of the kind of reporting that is needed.

The authors' analysis of healthcare systems outside the USA is skimpy and inaccurate in my opinion. The authors underplay the demonstrated efficacy of government-funded systems that outperform the USA system almost across the board in gross measures of outcomes (infant mortality and longevity) and vastly outperform the US system in regard to cost. They gloss over the fact that per capita costs in the USA are 2.5 times! the average per capita costs in other OECD countries. It is not as though the costs are say 10% above the average with comparable outcomes. They are 150% higher with worse outcomes. Instead of noting this and analyzing it thoroughly, the authors assert that waiting times and rationing of care are significant problems in those countries, assertions which are simply not borne out by the facts. Also the fact that (mostly) single-payer/insurer systems function well universally does not fit the authors' main thesis, so rather than revise the thesis based on this evidence they choose to ignore the evidence.

As a consequence of these limitations I rate the book with 4 stars rather than 5. Too bad, because most of the book is excellent.

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Review

I am taking a Health Care Management Strategy class and this book was recommended by our professor.

Very well thought and comprehensive book.

Some comclusions can be challenged, but the book bringing a new look on Health Care and provide solutions for improvements.

The U.S. health care system is in crisis. At stake are the quality of care for millions of Americans and the financial well-being of individuals and employers squeezed by skyrocketing premiums-not to mention the stability of state and federal government budgets.

In Redefining Health Care, internationally renowned strategy expert Michael Porter and innovation expert Elizabeth Teisberg reveal the underlying-and largely overlooked-causes of the problem, and provide a powerful prescription for change.

The authors argue that participants in the health care system have competed to shift costs, accumulate bargaining power, and restrict services, rather than create value for patients. This zero-sum competition takes place at the wrong level-among health plans, networks, and hospitals-rather than where it matters most, in the diagnosis, treatment, and prevention of specific health conditions. Redefining Health Care lays out a breakthrough framework for redefining health care competition based on patient value. With specific recommendations for hospitals, doctors, health plans, employers, and policy makers, this book shows how to move to a positive-sum competition that will unleash stunning improvements in quality and efficiency.

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