Flatlined: Resuscitating American Medicine

Contents

CONTENTS List of Figures and Tables ix Preface xi Acknowledgments xvii PART ONE Why the Uninsured Should Be Covered 1 Not Business As Usual 3 2 Unreliable Emergency Services 10 3 An Eroding Infrastructure 16 4 Fifteen Years Lost 25 5 Handed Health Care’s Leftovers 35 PART TWO Why Health Care Is So Expensive 6 Where We Are Headed 49 7 30 Percent Waste—or 50? 57 8 Poor-Quality Primary Care 67 9 Dangerous Hospitals 77 10 Violation of Dignity: The End of Life 94 11 Unnecessary Surgery 103 12 Perverse Payment Incentives 120 13 Three Pathways to Hospital Profitability 139 vii Prelims.qxd 10/10/08 3:27 PM Page vii 14 Pharmaceuticals: Remarkable Innovation, Shameless Puffery 157 15 Private Health Insurance: No Added Value 170 PART THREE Reforming American Health Care 16 Three Options for Covering the Uninsured 179 17 No Coverage Expansion without Cost Control 201 18 A Workable Plan for Reform 212 19 Establishing Standards 224 20 Prioritizing Primary Care 232 21 Reducing Spending on Hospitals and Specialists 243 22 Positioning of an American Medical Quality System 261 Notes 275 Index 313 CONTENTS viii Prelims.qxd 10/10/08 3:27 PM Page viii ...