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Persuasive (but "wonkish")Review Date: 2007-07-16
Only problem is he uses the word 'free'Review Date: 2007-07-13
Free Markets are HealthyReview Date: 2007-01-11
Extremely important book for an extremely important topic: health careReview Date: 2007-03-04
Cannon and Tanner's book starts with a foreword by the Hon. George P. Shultz: "We begin with a riddle. What country's health care system offers the best health services in the world, is consistently criticized for not being accessible enough, and yet is so accessible that overutilization is leading to runaway costs?" The answer is, of course, America.
The following 147 pages offers a detailed analysis of what's wrong with American health care (government and insurance industry policies that lead to overuse of medical services) and what's right (the strong remnants of a free market system that encourages innovation, high quality, at an often lower cost). Both detailed and heavily footnoted, but also very readable at the same time, "Healthy Competition" strikes the right balance between a dense academic paper and a clarion call for action.
In concluding the book, Cannon and Tanner write:
"Despite its marvels, America's health care sector continues to present troubling symptoms: excessive costs, uneven quality, a lack of useful information for patients and providers, extraordinary waste, and enormous burdens for future taxpayers. An accurate diagnosis points to too much government influence and too little choice and competition. Proposals to increase the role of government would aggravate these symptoms. More subsidies or controls would drain from the medical marketplace even more of the dynamics that drive other sectors of the economy toward lower prices and higher quality. The only sure remedy is to restore those dynamics to the health care sector.
"Although there are dark clouds on the horizon, we are heartened by the creation and steady growth of health savings accounts. HSAs have already begun to change private-sector health care from within, and will enable a reexamination of the role of government in health care."
The last citation in "Healthy Competition" comes from a June 1, 2004 Harvard Business Review article by Michael Porter and Elizabeth Teisberg. It deals with the oft-heard argument that we somehow should not apply free market principles to the health care sector:
"It is often argued that health care is different because it is complex; because consumers have limited information; and because services are highly customized. Health care undoubtedly has these characteristics, but so do other industries where competition works well. For example, the business of providing customized software and technical services to corporations is highly complex, yet, when adjusted for quality, the cost of enterprise computing has fallen dramatically over the past decade."
Cannon and Tanner accept this argument while also embracing the argument of many of the proponents of government control of health care because it is special and distinct from other parts of the economy - they just come to the opposite conclusion, concluding in their last paragraph, "...Unlike software, wireless communications, or banking, health care involves very emotional decisions, which often entail matters of human dignity, life, and death. However, we do not see the gravity of these matters as a reason to divert power away from individuals and toward government. Rather, we see the special nature of health care as all the more reason to increase each consumer's sphere of autonomy. The special nature of health care makes it all the more important that we use the competitive process to make health care available to more consumers - and makes it all the more important to get started now."
Two side notes of a personal nature: on February 1, 2007, I introduced AB 245, a bill that would allow the tax deductibility of contributions to HSAs (California is one of only four states that do not treat HSAs as tax deductible); and author Michael Cannon is someone I have grown to respect from our first meeting in 2004 as Lincoln Fellows of the Claremont Institute. I suspect we will be hearing quite a bit from Mr. Cannon over the next few decades - and, if policymakers are smart, they will listen carefully to what he has to say.
Reviewer: Chuck DeVore is a candidate for U.S. Senate in 2010, a California State Assemblyman, he served as a Special Assistant for Foreign Affairs in the Department of Defense from 1986 to 1988, retired from the Army National Guard as a lieutenant colonel, and is the co-author of "China Attacks."
CJFReview Date: 2006-03-20
The book makes clear that market based proposals to reform health care are designed to lower the cost of care and increase coverage. These are proposals that are critical to all Americans.
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Learn about telemedicine and telehealthReview Date: 2000-08-21
Review of Telemedice and Telehealth by Darkins and CAreyReview Date: 2002-02-11
The first chapter details basic definitions of the field. The next five chapters deals with the patient, physicans, Healthcare in general, and lastly specific telemedicine services. The authors suggest the formula for telehealth success as improved quality and access to care at a lower cost and without raising professional objestions.
I found the chapters developing the business case for Telemedicine and telehealth services most compelling. These markets are still in their infancy and are still struggling to develop their potential. The authors share with us their strategy for selling Telehealth services (page 157).
Telemedice and Telehealth, also provides a cautionary note. The authors indicate that to date they were not aware of studies demonstrating a viable telehealth model with the current legislation and reimbursement structure. Further issues such as licensure, quality assurance and backup systems remain to be clearly defined.
This book is an excellent read. Concise, articulate and timely. I would recommend this book to any one intersted in Telemedicine or Telehealth.
Comprehensive, useful for novices and specialistsReview Date: 2000-10-12
The future of health care thru high technologyReview Date: 2000-08-25
This important book begins the necessary critical conversation of defining the fundamental of concepts and terms, as well as those areas of current and future applications, involved in the merging of health care delivery and high technology systems. The authors wisely suggest using the term Telehealth to address the broad range of health applications which high technology, the Internet in particular, can greatly impact.
These concerns are set in the context of both a historical view of health care and society, particularly in the more technologically developed societies of the U.S. Western Europe and Japan, and these societiesÕ current and future trends toward change of lifestyle driven by their adaptation of new technologies. These are vital concerns, both within health care delivery in particular, as well as within the economic and social evolution of these societies in general.
Their book focuses on the patientÕs experience of health care service as facilitated by this new technology rather than being yet another discussion of the fascinating innovations within the technology itself, a very important distinction.
Being physicians themselves, authors Darkins and Cary have professionally grown up through the very cusp of change they are defining for us; they know the pre-high technology delivery of health care and have been witness to, and advocates for, the introduction of high technology to the health care systems in which each have worked, both in the U.S. and England.
Their book is both comprehensive in its discussion of the issues involved as well as being detailed in its coverage of those particulars necessary to see the overall picture clearly.
Because of the timeliness of this merging of high technology and healthcare delivery, one wishes this book could be made more available to a wider reading public through a greater promotional effort by the publisher.
Telemedicine and Telehealth is Now!Review Date: 2000-10-02


When the carbon hits the fan, life happensReview Date: 2004-05-21
This is an excellent book that uses the "parabolic" method of crisis experiences as comparitive guideposts to deal with life's contingencies. As it has been said the first casualty of war is the plan. Paul provides some rather calm and sage advises on how to handle the inevitable often shocking circumstances that present opportunities in life and business. You can't change what happens to complicate one's life, but with the proper actions taken, one can correct the course with an eye to the future.
Lesson Learned -- A Must Read for Senior ManagementReview Date: 2002-03-29
Thankfully, the author doesn't provide a checklist or formula but identifiable lessons by way of entertaining examples. The book is written in a casual narrative form, which makes it a quick (I finished it in 3 hours) and entertaining read. After putting the book down, I was left with a handful of insightful lessons, which I am confident I can apply to my work.
Good MedicineReview Date: 2002-03-26
The author, Paul Auerbach, a practicing physician and successful businessman, draws upon real-life experiences in the E.R. to instruct the reader as to how he or she might approach various management issues. In the introduction, Auerbach states that nothing is more revealing than letting your customers and employees tell you what they think and that if you set up a way to periodically endure unfiltered comments it can become the best stethoscope into the heart of your business. This insightful statement hit home for me, as it is the foundation of my coaching philosophy. I suspect it will ring true for you too.
The author shows us how the field of applied medicine can inform management. For example, just as most physicians possess a knowledge base that can be difficult to translate effectively into lay language for patients, so too do business leaders need to cut through their technical jargon in order to communicate effectively with their employees and customers. Whether in clinical medicine or a consumer electronics company, the leader must make information accessible to his or her followers.
I recommend this book to all organizational leaders - not only to those in the medical profession - without hesitation. For much less than the cost of a visit to your local hospital emergency room, Management Lessons From the E.R. is a valuable addition to your management toolbox.
Betty
Till
Executive Coach...
What the doctor orderedReview Date: 2002-03-25
From my 10 plus years senior management experience in building high performance product development organizations and helping business fix their product development problems, "Management Lessons from the E.R. : Prescriptions for Success in your Business" is just what the doctor ordered.
Life and companyReview Date: 2002-03-29
Guy Kawasaki
CEO
Garage Technology Ventures
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Validating and HelpfulReview Date: 2002-09-22
Eight years of living with chronic migraines has effected my faith, self-image, independence, relationships, work aspirations and what I consider my purpose in life.
At first I tried to minimize the migraines disabling effect but over time and with more acceptance I have, for the most part, found ways to accommodate and live with them.
Register describes many of the challenges of living with chronic illness. Sickness in our culture is seen as an enemy to be fought and defeated. These war images cast chronically ill people as victims, and it's sometimes seen as a character defect if we experience suffering, grief or fear. Instead of �battling� the illness we can accept it as something we live with that is our normal state of being. The realization that we can be happy and sick is a major lesson.
Our culture expects a person's disability to be a test of character or an opportunity for heroism. People effected with illness should not have to prove their value to others. We are not better or worse, no more heroic or cowardly, strong or weak than healthy people. We are people first not a disease.
Other hurdles for the chronically ill include: loss of autonomy, (self-reliance and being financially self-supporting carries the imprint of virtue). For the chronically ill not pulling your weight is compounded by the fear of becoming indigent and feeling different. Unemployment not only involves economic loss but the loss of identity, productivity, self worth and a sense of meaning. Register says it is important to separate our economic and identity issues from the quest of human worth. When we accept our illness we can stop looking for a cause to blame or a miracle cure.
Chronic Illness challenges our relationships. Adversity can bring couples closer but with chronic illness the adversity comes and goes on a regular basis. The crisis may even become the core of the relationship. Illness highlights and compounds the gender differences. Females are trained to show emotion and males to hide them. It is easier for women to "be there" for intimacy and shared vulnerability. Women often want simple consolation from their husbands, what they get instead is a rational solution. Seeing their mate sick leaves many men feeling powerless. When a relationship requires sustained expression of thoughts and feelings it may become burdensome for the mate.
Register illuminates patience as a way of life for the chronically ill. Acceptance means taking realistic control over how we live and being ready for chaos. The "one day at a time approach" helps. When pain grows intense it demands complete attention. It also helps to focus on the recovery instead of the traumas.
Most doctors are more comfortable caring for acute illness. When medications do not work the patient rather than the medication is often blamed. Few doctors are honest about the limits of medical knowledge and trust patients enough to be partners in care.
Register acknowledges that anger, fear and grief are healthy responses to physical suffering. The value of catharsis allows us to face the emotions head-on rather than avoid or dismiss them. It is reassuring to hear that having suicidal fantasies are a normal consequence of chronic illness and not evidence of losing hold. Since most people do not act on their suicidal thoughts, considering death as a way out of the pain often diffuses the suffering. Also, when we confront the suicidal fantasy head-on it looses its power. Register even came to regard her own suicidal fantasies as a treasured choice. Knowing that suicidal thoughts are a feature of the illness is empowering.
Instead of asking "why me?" the chronically ill are better served by the question "what now?" And for people of faith we might ask, "what do you want from me God?" which implies not penance but fulfillment of a mission. Instead of seeing chronic illness as a punishment for sin, an endurance test, a divine plan geared to your natural capacity or a random event Register recommends we see chronic illness and suffering as central to the human condition. It is our own share of life's condition - a way of life not an aberration. Register says, to live with passion allows us to live with the dynamics of contradiction in joy and sorrow, caring and indifference, in courage and fear, in friendship and alienation. Passion is a fully human and divine spark that burns with life.
To answer the question "what should I do?" Register says, "Just live your life, pain and all with attention and purpose." Lived fully, the experience of illness can free us from the curse of perfection. For people of faith learning to feel God's pain makes us more attuned to God's pleasure. Life is a beautiful tapestry being woven with our lives, it's pattern visible only to God.
Register redefines the disabled hero as one who demonstrates a capacity to come through multiple ordeals with their will intact. Instead of winners and losers, survivors have moments of courage, moments of cowardice, moments of determination and moments of despair, moments of glory and moments of humiliation. That many of us survive these ups and downs is a miracle that happens many times a day.
Register describes the ingredients of survival for the chronically ill: a sense of humor, tenacity, a will to live, discipline, inner strength, trusting ourselves, inner peace, acceptance, a support system, faith, skepticism, and a belief in a Higher Power and Purpose. Instead of saying, "There but for the grace of God go I" we might say, "Here, with the grace of God, I am." Our bodies are, after all, our medium for experiencing creation.
Truly a classic! This book can make you both smile and weepReview Date: 2001-06-20
Must reading; very supportiveReview Date: 1998-11-14
Truly a classic! This book can make you both smile and weepReview Date: 2001-06-19


A Wealth of IdeasReview Date: 2001-12-05
A goldmine of activity ideasReview Date: 2000-04-07
This is an exceptionally helpful bookReview Date: 1999-07-19

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This book is the reason I was able to birth my breech baby naturally!Review Date: 2005-08-08

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Important history of the role of the post officeReview Date: 2007-09-29

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The best book ever written on health care.Review Date: 1999-05-30


Great for future mothers, educators, midwives, etc.Review Date: 1999-12-06

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Reminders of things we should do but don't do, fairytale type of book.Review Date: 2008-10-06
Excellent ReadReview Date: 2008-09-29
Life changing book...Review Date: 2008-08-15
Great Idea!Review Date: 2008-08-28
Life's Lessons in Real Estate - General InvestingReview Date: 2008-07-31
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The book's greatest strengths may also be it's greatest weakness. This book is "wonkish" -- filled with hard data and logic. If you're looking for entertaining anecdotes or emotional arguments, this is not the book for you.