Health Care Reboot: Megatrends Energizing American Medicine

I am a recently retired physician who spent 40 years in the private practice of Primary Care. This gentleman's conclusions are self-serving lies. As anyone with eyes and ears can attest, the American healthcare delivery system is not a gem of well-lubricated efficiency delivering technologically miraculous care at an efficient price. Our system delivers the most expensive care in the world to the smallest proportion of society at the greatest per capita cost. I know -- I struggled with increasing frustration over 40 years to deliver health care within a system that was designed by, and solely for the financial benefit of corporate America. Any struggling family that has to pay more than 50% of it's monthly income on health insurance can tell you that. Our best opportunity to wrest control of the system from corporate profiteers was the Clinton plan in 1993. It wasn't perfect, but could have been improved as we progressed.You can tell that it was good by the ferocity with which the insurance industry and drug industry fought it off. But Americans are sheep, easily led to the slaughter. We should ask ourselves why it is that all other western postindustrial countries have single payer systems controlled by The People (i.e. the government), and are happier with their health care than we are. And spend about half of what we spend. And have better outcomes. Except for us. Canadians are overwhelmingly happy with their system, despite the propaganda of the American insurance industry. They can cherry pick negative stories, but the reality is that 65% of Canadians are at least "very happy" with their system. Can we say that?

This is a very well researched and well written waterfront tour of healthcare in America. While not trying to gloss over the problems and challenges, Dowling and Kenney provide a valuable counterpoint to the doom-and-gloom narrative of "the healthcare crisis" that so often dominates media coverage. The megatrends they describe in technology, consumerism, medical education, population health, mental and behavioral health are defining the healthcare system of today and present a vivid look into what the system is likely to look like in years to come.For healthcare administrators, Chapter 8 on consolidation and integration (and the difference between the two) in the healthcare system is essential reading. At Values Coach we work with many - often fiercely - independent hospitals and smaller health systems, and we do our part to help them compete to remain independent. But I agree with the authors that this will be an increasingly challenging road to take, and for many smaller organizations will eventually become untenable. So I will encourage our "fiercely independent" friends to carefully read this chapter and think about the futures of the organizations for which they are responsible.With healthcare headlines so often dominated by terms such as burnout, crisis, shortages, and the like it is refreshing to read about the megatrends that are moving the system - and the experience of those who work in and are cared for by that system - in a positive direction.

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There is a reason why Michael Dowling leads the biggest healthcare provider in New York. His new book, Health Care Reboot, demonstrates that he’s a true thought leader in the space. We can all benefit from his wise perspective as we collectively face no shortage of challenges, but also acknowledge the many things that are in fact working and working well. It covers everything from current issues in the spotlight such as behavioral health and psychological care, like improving treatment by analyzing how social and economic factors impact our health, along with describing new advances in fields like oncology and cardiology. In short, Dowling paints a picture of how we can get smarter about healthcare now and for generations to come. It’s a read I highly recommend.

An insightful take on healthcare today and core challenges and opportunities this country faces. Clearly written and well researched.