First, a Story: Tom Johnson's Belly Encounters Healthcare as It Has Been
Section 1. How We Got Here
Looking at Normal Countries
Economists Behaving Badly with Smoke and Mirrors
The American Ways of Healthcare
Possible Savings: Getting to Half
Level 1. Doing the Right Things the Wrong Way
Level 2. Doing the Right Things in the Wrong Place
Level 3. Doing the Wrong Things-and Not Doing the Right Things
Where Are the Biggest Savings?
Heroic End-of-Life Treatment
Computerization and Automation
Brute Force Cost Reductions
4. Healthcare Economics 101
The Convoluted Economics of Healthcare
Split Buyers, Split Sellers
Why the Ever-Popular "Cost Controls" Do Not Control Costs
Health Systems: More Complex
It's About to Get Really Complicated
Unit Costs vs. System Costs
The Two Core Rules of Economics
Section 2. What Must Be Done
6. 1. Explode the Business Model
The End of Fee-for-Service Healthcare?
What's Wrong with Competition?
On-Site Clinics without Employers?
Medicaid-Based Business Models
Disease Management Programs That Fail
Disease Management Programs That Work
Direct Primary Care-Online
A Brief History of Risk in Healthcare
Putting the Customer at Financial Risk
"But Capitation Doesn't Work"
Putting the Provider At Risk
Providers At Risk Behave Differently
Putting Providers Systemkally At Risk
Virtuous Deflationary Spiral
Explode the Business Model
7. 2. Build on Smart Primary Care
How a Medical Home Actually Works
Making More Money by Being a Better Doctor
Integration: It's Not Just "Kumbaya"
From Evidence-Based Medicine to Evidence-Based Health
Explode the Business Model and Build on Smart Primary Care
A Team Care Example: Diabetes
Getting on the Same Team with the Docs
What Makes a Team? A Scoreboard
Explode the Business Model, Build on Smart Primary Care, and Put a Crew on It
The Pareto Principle in Healthcare
More Help, Smarter, Earlier
10. 5. Rebuild Every Process
The Tough Business of Caring
Perfecting Clinical Processes
Measure It-and Get It Right
Other Industries: "Quality Is Job One"
The Institute for Healthcare Improvement
Comparative Effectiveness Research
The Lean Medical Practice
Analytics for the Country
Extending the Clinic into the Home
India and China: Globalization Cuts Both Ways
Cheap Biologicals and Biosimilars
Section 3. Making It All Work
Len Duhl, the Father of Healthy Communities
12. The Evil Profit Motive and the Virtues of Competition
Arguments for a Single-Payer System
Insurance Companies Are Evil
13. There Ought to Be a Law
Corporate Practice of Medicine
Anti-Kickback Legislation
End Fraudulent Rescissions and Claim Denials
Operating across State Lines?
Fixing the Pharmaceutical Industry
Why We Don't Get Legislation That Works
Beyond the Tipping Point: Rapid System Change
Automatic Cost Reductions
16. Beyond Reform-The Next Healthcare
Appendix A. Stupid Computer Tricks: How Not to Digitize Healthcare
