Review of Redefining Health Care

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Rating

7 Overall

7 Applicability

8 Innovation

7 Style

Review

Harvard professor Michael E. Porter and Stanford medical school professor Elizabeth Olmsted Teisberg offer a 450-page manifesto for fixing the US health care system. Their 2006 descriptions of insurers, providers, patients, governments and suppliers in a disjointed, directionless system proved sadly accurate, if somewhat longer than necessary. Porter and Teisberg advocate restructuring health care to address a “broken” system. They contend that hospitals should build reputations for excellence in treating a limited number of related conditions, and should assemble specialty teams around “full-cycle” treatment. The best would attract more patients, improve continuously and grow more efficient; the worst would go out of business.

About the Authors

Michael E. Porter explores value-based health care at Harvard University’s Institute for Strategy and Competitiveness, which he founded. Elizabeth Olmsted Teisberg teaches at Stanford University’s medical school and heads the Redefining Health Care consultancy.

 

Accepting Porter and Teisberg’s imaginative, optimistic solutions means adopting their faith in competition, “self-interest” and the belief that the marketplace can work when lives are at stake. It also requires quashing doubt about the perfection of data entry, analysis and reporting, let alone privacy protection. It means setting aside faith in physicians’ and nurses’ motivation to treat patients to the best of their abilities – if only they were left alone to do so. Instead of keeping providers honest through bureaucracy and paperwork, Porter and Teisberg advocate compulsory, mass data collection and reporting – at least as onerous, soul-crushing and problem-prone a task. Although Porter and Teisberg’s book predates the Affordable Care Act (ACA) and subsequent efforts to repeal it, and has thus become out of date, their concepts and solutions still resonate soundly in the health care argument.

Their lessons and recommendations for achieving “value-based” health care include:

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