Health Care Meltdown: Confronting the Myths and Fixing Our Failing System Book

	Foreword	xiii
	Prologue	xv
	Acknowledgments	xix
	Introduction: Confronting the Myths: Can America Halt the Slide Toward Health Care Meltdown?	1
	Our Poor Performance and Perverse Incentives
	The Search for a Comprehensive Solution
	Getting America Clued In
	"One Risk Pool"/ National Health Insurance
Part I	The Problem A Wasteful, Dysfunctional System and a Nation Kept Clueless
Chapter 1	Myths, Misinformation, and the Pursuit of Profit	13
	A Myriad of Myths
Myth #1	Everybody Has Access to Care Through the Emergency Room
Myth #2	We Don't Need to Fix What's Not Broken
Myth #3	"The Market" Is the Solution
Myth #4	Private Is Always Better than Public
Myth #5	Medicare Is Going Broke
Myth #6	We Can't Afford Universal Coverage
Myth #7	Americans Don't Want Rationing of Health Care
Myth #8	We Don't Want Socialized Medicine Like in Canada
Myth #9	The Insured Pay More To Help Cover the Costs of the Uninsured
Myth #10	Universal Coverage Will Overburden Our System
Myth #11	Costs of Research and Development Drive Our Higher Drug Prices
Myth #12	We Can Get to Universal Coverage Through Incremental Changes
Myth #13	Americans Won't Accept Single-Payer Universal Coverage
Chapter 2	America's Health Care: The Monster We Have Created	47
	Managed Care vs. Managed Cost: "Crazy Making"
	Unrealistic Expectations
	Ignorance of the Costs
	The Paperwork Nightmare
	Fraud and Abuse
	The Paperwork Could Get Worse
	Underutilization/Overutilization
(1)	The "Underutilizers"
(2)	The "Overutilizers"
Chapter 3	Monster II: Perverse Incentives Lead to Bizarre Outcomes	67
	There's "Gold in Them 'Thar' Patients"
	Creating the Demand: The Sky's the Limit
	The Ultimate Overutilization: "Boutique Medicine" for the Very Rich
	Opting Out: An American Privilege?
	Competition vs. Cooperation
	Prevention vs. Cure
	The Malpractice Conundrum
	Employer-Based Insurance: An Anomaly
	More Perverse Incentives for Providers and Patients Alike
	The Mental Health Scam
	The Patient Comes Last
	The Market vs. the Patient
Chapter 4	Delayed Care: Rationing American Style	90
	The Mantra of "Personal Responsibility"
	Some Terrible Consequences of Delayed Care
Chapter 5	Jumping Hoops for the Uninsured: Caring for Patients at a Community Health Center	97
	Why They Don't Come In
	The Medical Visit, Prescriptions, and Tests: Games We Play
	A Patchwork of Arrangements to Get Care
	Why Do Our Patients Think We Don't Have Universal Coverage?
	The Positive Side of Working With the Uninsured
Chapter 6	Squeezing the Patient: Co-Pays and Deductibles	110
	Why Do Physicians Support Co-Pays?
	Co-Pays That Hurt
	The "Safety Net" and Co-Pays
	The Larger Picture
Chapter 7	Religion and Health Care Reform: "Personal Responsibility" vs. Caring for the Needy	120
	How "The Market" Has Overridden Religion
	The Role of "Personal Responsibility"
	Free Clinics and WWJD
	Health Care as a Human Right in the U.S.?
Chapter 8	Public Health: We're All on This Planet Together	130
	Public Health and Chronic Disease
	The New Twist to Wake Us Up: Bioterrorism
Chapter 9	Blaming the Victim: A Bad Rap for Medicare	136
	Medicare as the Victim
	Expanding and Improving Medicare
Chapter 10	We Don't Want a Health Care System Like They Have in Those Foreign Countries	142
	Americans are Clueless on What Happens
	In Other Countries
	Our Much-Maligned Neighbor to the North
	Our Ranking in the World
Part II	Towards Finding a Solution
Chapter 11	The Price of Health: How Much Should We Americans Be Spending on Health Care?	153
	The "Good Old Days" Are Over
	Costs Are Going Up, Up, Up
	Ethics--and Profits vs. Patients
	"Expecting the World"
	The Future, Technology, and Costs
	The Answer Needs to Come From the People
Chapter 12	Don Quixote vs. the Establishment: Can the Medical-Industrial Complex Be Toppled?	169
	"The Evil Empire": How Bad Is It?
	Toppling the Windmills
	Appealing to Self-Interest--Does It Have a Chance?
	The Drug Barons
	The Camelots of Health Care
	The Lords of Medicine
	Tilting at Windmills From Beyond the Medical Establishment
Chapter 13	In Search of a "Uniquely American" Solution to Health Care for All	183
	Universal Uninsurance
	What About Poor Folks? Charity Care to the Rescue
	Potential Obstacles to Universal Uninsurance
	The Sad Truth: Fantasy May Resemble Reality
Chapter 14	Grassroots for Health Care for All: What Can Americans Do to Claim a Right to Health Care?	191
	Timing and the Changing Battlefield
	Groups, Old and New, Promoting Health Care for All
	The Community-Based Efforts
	More Talk, Less Progress?
	What Specific Actions Steps Will It Take to Motivate Grassroots America?
Chapter 15	National Health Insurance or Medicare for All: A Reality in Our Lifetime?	206
	It's Become Fashionable to Talk About Universal Coverage
	Why Don't the People Who Know Better Do Something?
	The Naysayers' Logic
Chapter 16	"Single Payer Will Not Fly": A Response	216
	Does "Incremental" Have a Chance?
	How About Affordability for the Patient?
	"Best" vs. "Better": In Search of Value for Our Money
Chapter 17	Needed for Affordable and Effective Health Care Reform in America: A Paradigm Shift for Prevention	222
	A Prime Example: America's Epidemic of Obesity
	What Are the Side Effects of Making Exercise "Mainstream"?
	Action Steps to "Put Prevention Into America"
Chapter 18	Epilogue: Beyond Universal Coverage	234
	Assuring Adequate Coverage
	Reclaiming Dignity
	Keeping America Clueless
	The Global Picture
	Steps We Must Take as a Responsible Nation to Improve the Health of Our Communities
	Afterword	245
	Notes	249
	Selected Bibliography	261
Appendix	Frequently Asked Questions About "One Risk Pool"	269
	Glossary of Terms	273
	Index	275
	About the Author	281