Reframing Healthcare: A Roadmap For Creating Disruptive Change by Zeev E. Neuwirth MDMy rating: 4 of 5 stars
This is a well-organized roadmap for addressing all that ails the healthcare system. Dr. Neuwirth is thorough and convincing. The great bonus it offers is that is is free of all political vitriol and platitudes - something I was concerned about when I embarked on this book.
Chapter after chapter I was struck by how much our public education system has in common with our healthcare delivery systems. Both are ginormous and complex, both are scandalously expensive (education - a terrible financial burden on taxpayers; healthcare - an enormous financial burden on families and businesses and governments) and both are pretty lousy. Several times, I actually substituted the words "public education" for "healthcare" and every sentence totally worked. Interesting, right?
I would pair this book with Pivot to the Future as I would pair a fine wine with a particular dish, and I'd suggest reading Reframing Healthcare second. The Pivot book will grease the skids and you will better grasp the kind of disruption sought by Neuwirth. You will better understand the importance of timing and how, in light of the direction of all manner of enterprise in the 21st Century, you will know that not acting boldly is not an option.
Neuwirth's offers very specific recipes for building a healthcare delivery system of the future. I really appreciated and admired this specificity.
His recommendations for reframing healthcare require imagination and are best viewed through the lenses of technology. The role of a customer-centric delivery system and digital and telemed delivery systems were my favorite parts of the book.
The elephant that remained in the room until the very end of the book is the role of the individual in achieving meaningful progress in reducing the burden on the healthcare systems by caring for their own health. Neuwirth does not call it this - he put this issue under the heading of "social determinants", which subtly places it all at the feet of a faceless, nameless group. Surely, there are social determinants to health (poverty, environment, lack of education, etc). This is very real. But, here is where public education and healthcare share many of the same fundamental issues. Whether rich or poor, whenever we decide to have BIG matters - like the education or health of our kids - handled by others entirely, the abdication can become part of the problem. I think this book would have had even more impact if there had been a chapter devoted to personal responsibility (at the individual level) to become informed and to make better choices. We seem to accept the legal principle that ignorance of the law excuses no one but when it comes to matters of health and education, many of us shrug and wait for others to do it for us.
More than half of healthcare expenses arise from behaviors and lifestyle choices that cause illness and disease processes. The poor and the down-trodden have an added burden, that is for sure. When I was poor, I carried a heavier burden to make wise choices. I remember this well, and it is why I think promoting change at the individual level, while recasting and reinventing the system that delivers healthcare is the one-two punch needed for a truly disruptive pivot to the future of healthcare.
I learned a great deal about the healthcare industry problems by reading this book and I was very encouraged by Dr. Neuwirth's corrective prescriptions.
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