The basic health care system in the United States is not working
and must be fixed. The cost of a new, effective system of health
care delivery would be instead of rather than in addition to what
the US population is now paying for an inadequate, incomplete
system. We must put the fiscal responsibility for health care
delivery on the medical care sector that makes the decisions on
what medications, what procedures and who gets treatment and when,
that is, the providers of care, mostly the doctors. By doing this
we can correct the more than fifty percent overpayment and misuse
of funds currently in vogue. The book deals with the concept of the
possibility of eventual coverage of everyone through the Medicare
system as the current population ages. It explains the leverage
that that single payer universal system such as Medicare, can
generate to change the incentives for the providers of care
resulting in a reduction of the overall cost. It also sets forth
the concept of choice for the patient, the allocation of resources,
and the restructuring of the medical education system as well as
the recruitment and training of providers. Other problems such as
organizational development, provider groups, malpractice,
reinsurance through a universal system and other solutions are also
dealt with. Today 45 million Americans have no health care
coverage, while approximately 50 million are under insured due to
high deductibles and co-payments. Many who are eligible for
Medicare, federal health care insurance for the aged and Medicaid,
federal health care for the poor, may be without coverage due to
lack of access to services in the areas that they live. Practical
solutions to these problems areaddressed. Robert Gumbiner, MD, with
more than 40 years experience in the health care field as a
practicing physician, a manager and a force in medical management
education, derives much of his experience from successfully
developing and managing one of the largest managed care companies
in the United States for over 30 years. Drawing on this extensive
management experience as well as years of studying health care
systems around the world, Robert Gumbiner debunks the myths held by
opponents to national universal health care and capitated
prepayment. His development of the first capitated prepayment plan
for Medical in the 60's in California and first contract for
prepayment Medicare on the West Coast in the 80's gave credibility
to his ideas that succeeded in reducing health care costs. He shows
step-by-step how we arrived at our current dysfunctional system and
argues persuasively how we have been misled by special interests in
the medical/industrial complex into thinking a health care system
funded through the government and managed for effective utilization
will eliminate choice. In the final analysis the book's major theme
is that the cost of a complete comprehensive system is "instead of
and not in addition" to what we are currently paying and how to go
about instituting such a system. It offers solutions that have been
developed by the author throughout his long career in managing
health care delivery systems. It is not a theoretical concept but
based upon ideas, errors, successes and a logical, practical model.
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