Reforming Health CareThis timely 2004 publication, which is aimed at a mainstream consumer audience, provides information about one of the most timely yet contentious issues in the U.S., namely reforming health care.

Overall, the author, a former resident of Canada, and President of the Pacific Research Institute, provides a strong economic focus and a concise commentary on health policy and care delivery in the U.S. and Canada. She clearly defines and explains similarities and dissimilarities between these two North American health care systems and offers general recommendations for action in the U.S. As an approach to change, she presents the case for adopting key reforms to enable the U.S. system to flourish and the Canadian system to solve key problems.

Some of the key themes involve the impact of unintended consequences and the paradox of the health care business. For example, an inadvertent result in the U.S. system is the existence of incentives for providing good health care while degrading the doctor-patient relationship through silo cost-driven management. For Canada, the national system of care for all citizens drives select patients or classes of families to seek care outside the system in order to obtain timely care. The business paradox lies in the drive for innovation that expands treatment options with increased costs but that does not yield cost savings, as is sometimes evident in other industries (e.g., computer chips). The author also emphasizes the many opposing goals in the two health care systems and the contradiction that health care is expensive for payers because it is cheaper for consumers.

Important legislative actions for policymakers to take emanate from a blended political philosophy of free-market proposals from U.S. Republicans and broader-coverage U.S. Democrats that might be successful from an economics standpoint. For instance, she quotes Nobel Laureate Milton Friedman about the illogical nature of the U.S. health care system and its reliance on employer-provided medical care. Although this book was published in 2004, the year of a U.S. Presidential election, the author does not specifically refer to party candidates or political party platforms. Instead, she presents an “arm’s length” commentary of the U.S. and Canadian systems and supports her statements with factual data as well as references, thus inviting further inquiry on solving the problems of health care objectively. pharmacy united kingdom

Unlike the format of many other books, the introductory section in Miracle Cure is rich with information, setting the tone about the key reforms needed to solve the health care crisis.

In Part One, the author explores the U.S. health care system from the multiple perspectives of payers, providers, and patients. She address the evolution and role of government in health care, third-party payers, the inability of consumers to receive the best health care at the best price, the problematic relationship between health care and employment (is there a better way other than employer-sponsored health care?), the proper roles of physicians and insurance companies, and solutions for the elderly. Ms. Pipes also asks a pertinent question: why not crack down on pharmaceutical companies and just import cheap drugs? Finally, she addresses the future by tackling lawsuits, the role of quality, and consumer-driven health care in the U.S. Throughout the book, she presents the key themes of expanding consumer choice as a vehicle for change and reforming the U.S. tax code in order to realign incentives to ensure more logical decisions and choices in health care programs.

In Part Two, Ms. Pipes reviews the Canadian health care system from multiple perspectives and from the viewpoint of mainstream readers. She explains the single-payer system, the origins of the Canadian system, how the debate in Canada affects the controversy about the U.S. system, the roles of national or provincial governments, employers in the private sector, consumers in Canada, and the prognosis for the Canadian system. The book also mentions the Romanow Commission Report and recent events in Canada related to possible solutions for the country’s health care problems. A key theme throughout Part Two is the need to legalize competition in the national-provincial health care system. cialis canadian pharmacy

In general, Miracle Cure offers compelling data with references and information about current issues as well as realistic options for reform in the U.S. and Canada. The book would make good reading for P&T committee members, advocates of health care changes, and those seeking to learn more about the economic implications of health care policy in both countries. I recommend that this book be included in health care-related libraries as well as in curricula for undergraduate and graduate students in the health professions.

Although the text is somewhat choppy in places, readers will be able to easily understand the book’s series of short chapters and clear messages.