Howard Dean's Prescription for Real Healthcare Reform: How We Can Achieve Affordable Medical Care for Every American and Make Our Jobs Safer,   ISBN:9781603582285

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Howard Dean should keep shouting it out. I think he sums up the situation clearly and concisely. He presents a rational approach for resolving the health care crisis we now face in the United States.

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Howard Dean makes an easily understood presentation of the crisis in health care and what he proposed will resolves these problems. Dean was distressed to see how often health care insurers stopped covering someone once they became ill. He notes the Congressional Budget Office calculates that, in the individual health care insurance market, that 29% of premiums pay for administrative costs. He found most insurance companies use of to half their expense on executive salaries, administrative costs, and profits to shareholders.

Dean notes 47 million do not have health care insurance. 25 million have such insurance but can't afford their share of the costs to see a doctor. Many face either bankrupting themselves to pay for health care or doing without.

Many states have weak laws regarding health insurance, which is regulated by state laws. Many states allow premiums to increase drastically. Many allow coverage to be denied to health conditions that arise later, sometimes upon review and sometimes even more than a year after purchasing the policy. Some policies only provide minimal coverage, such as up to $50,000 in lifetime costs or $1,000 for hospitalization. It is hard for the public to understand health care insurance policies. They are deliberately written in technical language the public finds trouble understanding.

Dean notes that Canada's national health care system attracts businesses to locate there. Establishing instead in the U.S. entails employers making large enough health care expenditures that it is cheaper for them to locate in Canada.

Health care insurance should be available to everyone, Dean writes. It should be affordable, rather than something that contributes towards half of all bankruptcies. Health care should stay with an individual and not be dropped when a person changes jobs. People should be allowed to keep their existing coverage, if they wish. A tax credit should be provided to small businesses to help them pay for their required health care insurance. Our efforts on disease prevention, health care research, and health information technologies should be increased.

A public insurance option would have lower administrative costs. It would drive private insurance to compete by lowering their expenses and their costs to customers. This system would preserve the wishes of Americans consumers to have choices.

Americans deserve informed choices. This is particularly important when it comes to the public being able to understand their choice on pharmaceuticals and how different brands of similar drugs work and what their possible side effects are.

Dean states a 5% gas tax would pay for health care insurance costs. The costs of the public insurance could by transferring excessive Medicare payments to the public insurance system.

Private insurance and business interests are fighting to protect their own interests against health care reform that would be in the public's interest.

The U.S. spends $5,711 per capita on health care compared to $2,989 in Canada and $2,317 in Great Britain. The U.S. spends 15.2% of its GDP on health care compared to 9.9% in Canada and 7.8% in Great Britain.

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Dean, as governor, began what you would call today a "public option" in Vermont, back in the 1990s. The economy boomed and insurance companies did not go out of business.

Besides that, Dean reviews the health care systems of many European countries and how they do single payer, and a number of other combinations of private and public systems. He follows their past evolution into universal care. There is a road map where we are going in this book.

Other subjects, facts, statistics to spike the lies and misinformation on this subject such as this on tort reform:

"The total cost of malpractice constitutes just 0.46 percent of total healthcare expenditures, and settlements have grown modestly with inflation. While approximately 98,000 people die each year from negligent treatment, a mere 2 percent (2%) sue their physicians. As health policy analyst Maggie Mahar [author of "Money-Driven Medicine"] observed, 'A very small group of doctors are losing or settling malpractice lawsuits, but they are losing big.' Between 1990 and 2002, '5.2 percent (5.2%) of doctors were responsible for 55 percent (55%)' of all malpractice payouts." p.90-91

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At a time when there is far more heat than light being shed on the debate over how to fix America's broken health care system, Dr. Howard Dean brings a much needed voice of reason to the battle. For all the authoritative guff being thrown around by talking heads, pundits, talk radio freak show hosts, and grand-standing Congressmen, Dr. Dean has some real qualifications in this area.

As a young man, he spent several years working on Wall Street, learning enough about the financial trade that going back to school to become a doctor seemed like a good idea. As a practicing physician, he became interested in politics while seeing on a daily basis how the personal and the public intertwine. As a governor, he initiated policies to make his state both healthier and better off financially. As a presidential candidate and later as the national chair of the Democratic Party who developed the 50 state strategy that put Democrats back in power in Washington, he became intimately familiar with the needs and problems of the entire country.

Dr. Dean has now produced a slim volume that breaks the debate down into easily understood components, written in plain talk. He details what is wrong with health care in this country, how it fails so many, cripples our economy, and costs too much. He lays out solutions, explaining what is needed, why a public option matters, how costs can be controlled, and how it can all be paid for. He explains why this has been so hard to do, and who is standing in the way. He explodes the myths being thrown around, explains how other countries have each developed their own solutions that work and work well, and points out that this is NOT a radical new idea in this country. He finishes with a call to arms, laying out the stakes and detailing how to mobilize your neighbors, your country, and yourself.

While getting health care reform in America right carries huge political consequences for both major parties, this is not an ideological book. It's a very pragmatic effort: to show what is wrong, to demonstrate that it is a problem other countries have solved, and to lay out a solution that works for America. Health care reform is not a Democratic issue or a Republican issue; it's an American issue. Dr. Dean has the prescription for what ails us.

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The subtitle of this book should really be "More about President Obama's health care reform", as that seems to be the major thrust of the book. Regardless, I found this book to be very informative and helped me see beyond all the sound bites in the media about health care. At times my opinions were swayed towards this reform by his book.

Dr. Dean does give some good background information and insight from his medical profession experience. However, at times, he tries to lay blame on Republicans for muddying the issues, but at times he resorts to the same tactics. He paints a bleak picture for a person under the current system on page 6, talking about a typical family: "they would certainly have lost their house and everything else they own" due to huge health care expenses. But he ignores that filing bankruptcy could prevent the loss of a home and many possessions.

He does highlight some causes of our current problems that aren't commonly thought of, such as the effect of meat producers over-use of antibiotics when raising animals for food, contributing the problem of antibiotics resistance in humans; the importance of prevention and wellness programs; and provides details to shed light on some common myths. I was surprised to learn that malpractice insurance expenses are only about 2% of total health care costs. Now that doesn't mean that isn't an issue, especially for doctors, but I was surprised how low it was. Another staggering figure is Americans spend $700 billion annually on tests and treatments that cannot be shown to improve health.

It is evident that this book was rushed to print as there are some sections that seem rushed, and there is some repetition of information. One example is the otherwise helpful section on other country's health plans. For France, it says that "the French spend only 11 percent of their GDP on healthcare" but that the Swiss "spend 11.5 percent of the GDP on healthcare, the second highest in the world." Only --implying a low amount-- 11% compared to 11.5% being the second highest doesn't line up.

Another major issue is he doesn't really explain how the government could reduce costs compared to private insurance, when Medicare is currently scheduled to be broke (and the book mentions this) by 2017?

Overall, this is a good summary of the issues of health care reform, and would help anyone understand the proposed reforms. It is easy reading, it doesn't get bogged down in spurious details. One thing that would have been helpful is a glossary of terms, such as "single-payer plan."