New book looks at repairing a broken health system

Dartmouth-Hitchcock authors unravel the problem of modern health care delivery

The complexities of the U.S. health care delivery system is a problem that continues to grow as more Americans grapple with treatment decisions, meetings with multiple providers, and costs that often seem out of control.

It’s a situation that physicians William B. Weeks and James N. Weinstein address in their book, “Unraveled: Prescriptions to Repair a Broken Health Care System.”

Both physicians teach at the Geisel School of Medicine at Dartmouth College; Weinstein also is CEO of the Dartmouth-Hitchcock health system.

“We spend far too much money on health care, and the impact of all that spending varies significantly based on where one lives and where one obtains care,” Weeks and Weinstein write. “Few players in the health care arena – whether patients, providers, or payers – are satisfied; most find the current construct of health care delivery inconvenient, incoherent, and even scary.”

In the book, Weeks and Weinstein offer steps that patients can take to ensure that their care is effective, efficient and satisfying, and that they have the information necessary to make the best health care decisions for themselves and their families.

In a series of scenarios based on actual clinical experience, Weeks and Weinstein analyze the entire health care process, from gaining access to the health care system, to the office visits, through testing and diagnosis, to treatment and payment, and through end-of-life issues. 

Weinstein writes, in part, based on the experiences of his family through the illness and death at age 12 of his daughter Brieanna, who battled cancer for 10 years.

“I have had a very personal – and unfortunate – experience, one that has transformed my life and that of my family forever, and has encouraged me to write this book. I want others to better grasp the challenges inherent in the current health care system, to see what is possible, and to understand why health care delivery needs to move from a system based on volume to a system of value based on outcomes,” he writes. “We need a sustainable health system that is focused on the health of communities and populations and not on growing market share; a system that moves away from fee-for-service reimbursement … toward reimbursement contingent on achieving the best possible outcomes at the lowest possible cost.”

“The irony is that America has the best health care available in the world – it has pockets of excellence wherein exceptionally delivered, high-value care is the norm,” writes Weeks. “But it also has enormous problems with access to care, the ability to consistently deliver high-value care, and waste. I fear that if we do not get health care costs under control – now – the debt that will continue to be created will bankrupt the next generation, a generation already hampered by high levels of debt. We have the tools necessary to improve health care efficiency. We need to install required supportive structures, carefully evaluate the effectiveness of health interventions, show the results of that deployment, and work together to improve the nation’s health.”

“Unraveled: Prescriptions to Repair a Broken Health Care System” is available on Amazon. All proceeds from its sale go to support the physical, emotional and educational needs of children with severe illness and their families. 

Categories: Health