Reinventing American Health Care et plus d'un million d'autres livres sont disponibles pour le Kindle d'Amazon. En savoir plus
EUR 25,40
  • Tous les prix incluent la TVA.
Il ne reste plus que 1 exemplaire(s) en stock (d'autres exemplaires sont en cours d'acheminement).
Expédié et vendu par Amazon.
Emballage cadeau disponible.
Quantité :1
Reinventing American Heal... a été ajouté à votre Panier
Amazon rachète votre
article EUR 4,37 en chèque-cadeau.
Vous l'avez déjà ?
Repliez vers l'arrière Repliez vers l'avant
Ecoutez Lecture en cours... Interrompu   Vous écoutez un extrait de l'édition audio Audible
En savoir plus
Voir les 2 images

Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System (Anglais) Relié – 27 février 2014

Voir les 3 formats et éditions Masquer les autres formats et éditions
Prix Amazon Neuf à partir de Occasion à partir de
Format Kindle
"Veuillez réessayer"
"Veuillez réessayer"
EUR 25,40
EUR 13,49 EUR 13,49
"Veuillez réessayer"
EUR 16,35

Offres spéciales et liens associés

Vendez cet article - Prix de rachat jusqu'à EUR 4,37
Vendez Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System contre un chèque-cadeau d'une valeur pouvant aller jusqu'à EUR 4,37, que vous pourrez ensuite utiliser sur tout le site Les valeurs de rachat peuvent varier (voir les critères d'éligibilité des produits). En savoir plus sur notre programme de reprise Amazon Rachète.

Détails sur le produit

En savoir plus sur l'auteur

Découvrez des livres, informez-vous sur les écrivains, lisez des blogs d'auteurs et bien plus encore.

Dans ce livre (En savoir plus)
Parcourir les pages échantillon
Couverture | Copyright | Table des matières | Extrait | Index | Quatrième de couverture
Rechercher dans ce livre:

Commentaires en ligne

Il n'y a pas encore de commentaires clients sur
5 étoiles
4 étoiles
3 étoiles
2 étoiles
1 étoiles

Commentaires client les plus utiles sur (beta) 70 commentaires
33 internautes sur 35 ont trouvé ce commentaire utile 
Six Megatrends: Agree or disagree? 24 mars 2014
Par Philip Lederer - Publié sur
Format: Format Kindle Achat vérifié
Ezekiel Emanuel just published an important book with a great title, "Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System." In it, he describes the history of health care reform in the US, gives an overview of the Affordable Care Act (ACA), and speculates about future trends in American health care.

The concluding chapter of Emanuel's book is entitled, "Six Megatrends in Health Care: The Long-Term Impact of the ACA." I will devote this review to discussing his six "megatrends."

Megatrend 1) The End of Insurance Companies as We Know Them

Emanuel argues that health insurance companies will "shift their business to focus on offering services they have expertise in, particularly analytics, actuarial modeling, risk management, and other management services...." or "transform themselves into integrated delivery systems," or they will go out of business. This seems quite plausible. However, I think it will depend on how the ACA implementation goes over the next several years. If insurance companies raise their rates, there could be major political fallout.

Megatrend 2) VIP Care for the Chronically and Mentally Ill

Emanuel argues that "tertiary prevention" for chronically ill people with diabetes, heart disease, cancer, etc, and mental health care for people with depression/anxiety, will become an increasing focus of our health care system. I agree. I've taken care of many patients with chronic diseases and mental illness who cycle in and out of the hospital. The question is if our fragmented health system can provide coordinated, community-based care for these vulnerable people. Doctors and nurses must learn to use a biosocial approach when taking care of marginalized patients with chronic disease and mental illness.

Megatrend 3) The Emergence of Digital Medicine and the Closing of Hospitals

Emanuel writes: "Digital medicine will allow physicians to monitor patients remotely anywhere they are, get labs and many imaging tests done, and perform interventions once done exclusively in the hospital." I agree - sort of. We are rapidly headed into a digital era. More health care will be provided in the community, and digital devices will continue to proliferate. But will these digital devices provide value for money? Or will the hype outpace their effectiveness? Unfortunately, so far, the hype is winning.

Megatrend 4) The End of Employer-Sponsored Insurance

This controversial megatrend was analyzed in yesterday's front-page New York Times article. I think this megatrend is very difficult to predict. It depends on a number of political and economic factors. Will America's health insurance system remain constant, or will it move 1) towards a Republican system based on tax credits, or 2) towards a single payer system based on universal health coverage, or 3) a Kaiser-like group model? The latter is the most likely.

Megatrend 5) The End of Health Care Inflation

I'm definitely not an economist, but I'm not sure I agree with Emmanuel that the ACA will succeed at controlling the growth in health care costs. In his book, Emanuel admits that the ACA didn't go far enough on payment reform, and that there remains "a serious misalignment between what we want physicians and hospitals to do in terms of improving value, efficiency, and reducing unnecessary care and how insurance companies, Medicare, Medicaid, and others pay them." As long as our fee-for-service system is around, and Medicare payments and RVUs are biased towards specialists, the growth of health care costs won't be controlled.

Megatrend 6) The Transformation of Medical Schools

I agree with Emanuel. Medical schools must change, and become much more team-oriented, community health oriented, and digital medicine oriented. The problem is that medical school curricula are very difficult to change. Can they begin to change rapidly? I'm not sure. If they can, it will require a major awakening of medical students and faculty.
With the enormous amount of material for physicians to learn, does reducing the length of medical school from 4 years to 3 years really make sense? I don't think so. I think it would be preferable to keep medical school at 4 years and subsidize medical school tuition, or provide 100% debt forgiveness for medical students who enter primary care careers. The National Health Service Corps is a good program, but it doesn't go nearly far enough. If medical school is reduced to 3 years, will the training physicians receive really be sufficient?
9 internautes sur 11 ont trouvé ce commentaire utile 
Somewhat optimistic 17 mai 2014
Par Deborah Sue St Clair - Publié sur
Format: Format Kindle Achat vérifié
This book, like the affordable care act, was born from a combination of idealistic beliefs that the dysfunctional health care system was somehow separate from the dysfunctional class divided society that it supports and that the health care systems fails because of inefficiency within itself. In reality the system re-aligns itself periodically according to the payments system, and in this sense delivers what society asks of it to do. The book supports the myth that better technology and electronic health records will allow advanced data mining to discover new medical truths and improve efficiency, in spite of the fact that every advance in technology beyond immunization has raised costs.. It celebrates the highly efficient veteran's administration hospital system as the best we have.
All this has some validity, but it was written before the Snowden revelations and before we discovered that the veterans hospitals cook the scheduling books before reporting their outcomes, bringing into disbelief all that these hospital system claims.
But I was happy to read this book, and it is a smooth fast read giving insights into what the health care planners of the federal government read before they wrote the bill that congress voted after a year of heated debate, but never actually read themselves.
28 internautes sur 39 ont trouvé ce commentaire utile 
Excellent Overview of U.S. Health Care 7 mars 2014
Par Loyd E. Eskildson - Publié sur
Format: Relié
American health care leads the world in costs - 18% of GDP (while excluding about 15% from insurance coverage), vs. 4% for Singapore (excluding no-one) at the low-end. It also infects 5% of hospitalized patients - of which nearly 100,000 die, and kills another estimated 44,000 - 98,000 from other hospital errors. Surely this complicated mess deserves rethinking. Unfortunately, getting from the mess we have now to something akin to the high-quality, much-lower cost care in Singapore, South Korea, Japan, and Taiwan has proven beyond the capability of America's legislative leaders. Decades of failed prior attempts, followed by compromise after compromise was required to even get the limited improvements afforded by the ACA when it was enacted in 2010.

Dr. Emanuel clearly likes the ACA - understandable given his role in its development. However, he minimizes trying to sell the ACA, doesn't mince words excoriating the initial ACA rollout efforts, and focuses on explaining our current complicated, dysfunctional system. I'm very hopeful that one of ACA's mandates (electronic medical records) will prove far more valuable than imagined, helping to identify important interactions, improve treatment protocols, and save lives. Improving access to care will also save lives. Similarly, encouraging the growth of accountable care organizations with bundled payments should also save lives and reduce costs by incentivizing quality improvement and removing incentives to over-treat. Finally, taxing 'Cadillac' plans will also hopefully make a dent in cost control.

An excellent and objective overview of complicated subjects
1 internautes sur 1 ont trouvé ce commentaire utile 
The best part of this book is its title which it ... 25 août 2014
Par Donald Hutchinson - Publié sur
Format: Relié
The best part of this book is its title which it then digresses from immediately. It is fascinating to read the candid account of horse trading that took place in order to secure the support (or head off antagonism) of special interests. Despite aims of bending the cost curve, it made concessions to Big Pharma, to Insurance companies (to avoid the "Harry and Louise" ads. It is amazing that the AMA did not have Malpractice Reform as a priority, It blatantly sought the support of women with free contraception, of the AARP by canceling he donut hole, and by extending medical coverage to college aid kids (thus increasing dependency on company paid insurance). A msu read or anyone who seeks information that Washington is dysfunctional. and that voter democracy is dead.
1 internautes sur 1 ont trouvé ce commentaire utile 
Lifted the clock of complexity into today's US healthcare system 17 juillet 2014
Par Neil Benson - Publié sur
Format: Format Kindle Achat vérifié
I'm a Brit living in the US. I'm used to the UK National Heath Service which offers great healthcare outcomes and reasonable value for taxpayers' money. Arriving in the US I find myself completely confused by a complex, bureaucratic, expensive private healthcare insurance system. Emanuel's book offered a comprehensive and insightful history of the US healthcare system and explained all the complexities of co-insurance and co-pays. The main topic, of course, was the Affordable Care Act and how it came to pass, what it set out of delivered and the compromises along the way. Emanuel was an architect of the ACA and is principles and pride shine through his writing, but that doesn't stop him pulling his punches when criticizing the Act's failings. An enlightening read.
Ces commentaires ont-ils été utiles ? Dites-le-nous


Souhaitez-vous compléter ou améliorer les informations sur ce produit ? Ou faire modifier les images?