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The Cure: How Capitalism Can Save American Health Care [Hardcover]

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Item Number 393509  
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Item Specifications...

Pages   325
Est. Packaging Dimensions:   Length: 9.1" Width: 6.3" Height: 1.1"
Weight:   1.1 lbs.
Binding  Hardcover
Release Date   Oct 9, 2006
Publisher   Encounter Books
ISBN  1594031533  
EAN  9781594031533  

Availability  0 units.

Item Description...
Everyone knows that the American health care system is in crisis. Skyrocketing costs and ever increasing bureaucracy have traumatized consumers and doctors alike. In The Cure, Dr. David Gratzer brings a welcome dose of common sense to bear on this subject. Drawing on personal experience in both the Canadian and the U.S. system, he shows how paternalistic government involvement in health care has multiplied inefficiences, discouraged innovation, and punished patients.

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More About David Gratzer

Register your artisan biography and upload your photo! David Gratzer a physician, is a senior fellow at the Manhattan Institute. Dr. Gratzer is the author of The Cure: How Capitalism Can Save American Health Care. His writing has graced the pages of dozens newspapers.

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Reviews - What do our customers think?
Ridiculous Bias!  Jun 25, 2008
"The Cure" is possibly the most biased, useless book on American health care - omitting problems with conservative nostrums, and overstating issues with government involvement.

"The Cure" begins by relating stories of patients waiting for care in Canada's publicly financed health care system, pointing out that some die as a result. Far more frequently reported deaths in American E.R.s waiting for care are ignored. Gratzer belittles the uninsured problem - pointing out that most reported as such are in that category for only part of the year, while ignoring the fact that coverage breaks create long-term non-coverage of pre-existing conditions and liability for overwhelming medical bills.

Gratzer's prime argument is that restricting patient choices (HMOs; Medicare and Medicaid) brings higher costs - since HMO restrictions are primarily aimed at holding costs down, and most Medicare and Medicaid do not limit choice, I have no idea what this is based on. He then goes on to complain about Medicaid's basically eliminating deductibles - perhaps he'd rather wait until they show up in the E.D.? (A 6/26/08 WSJ article reported that 38% of uninsured delayed/did without care because of cost concerns; 17% of those with insurance did so also.)

Gratzer's ire is next directed at FDA delays in approving new drugs - ignoring the fact that the vast majority of "new" drugs now are "me-too" versions of existing drugs (eg. Vytorin - 20X as expensive as equivalent existing drugs), and a few even are deadly (eg. Baycol, Vioxx, Avandia, Thalidomide). Drug companies complain about billions required to bring new drugs to market, then forget to mention that most of these funds are supplied by government research grants, that much of their research is statistically invalid and/or misleading, and that Americans pay more than any other nation for prescription drugs.

Medical Savings Accounts (MSAs) are touted as an alternative to employer-provided health insurance - great if one has a 6-figure income, useless at near minimum wages. Gratzer also ignores the high administrative costs and selective enrollment/disenrollment machinations of insurers - especially those covering small businesses and individuals. Then there are the embarassing comparisons between costs of privately- and publicly-provided Medicare coverage and/or drugs.

Wennberg's practice-pattern variation is covered - way too briefly. Worse yet, Gratzer fails to point out that this presents an ideal opportunity for government intervention to reduce costs while improving quality. (CT angiograms are widely condemned as greatly overused to build revenue while having little medical value, at the same time subjecting patients to cancer-causing radiation 1,000X that of a regular x-ray.) Similarly, the 100,000+ deaths/year due to medical errors. (The latter have been shown to be best addressed through computer-assisted prescribing, steering patients to highest-volume providers ("practice makes perfect"), and intensivists in the ICU.)

The "good news" is that Gratzer correctly identifies the paucity of health care outcomes data as impeding objective consumer choice, then fails to recognize that this has best been addressed to-date by government actions (eg. N.Y. vs. CABG results) and that it is always strenuously opposed by health care providers with capitalist motives. On the other hand, those needing emergency care, especially out of their normal area, are not in any position to use such data - unless enforced somehow by government mandate.

Neither conservatives nor government interventionists (eg. today's New York Times reports that competitive bidding offers considerable savings in medical equipment) have all the answers. Gratzer should start over, using that as a premise.
Because Everyone Seems to Need The Cure  May 11, 2008
The Cure: How Capitalism Can Save American Health Care is an excellent resource on health care economics and the history of health care policy. The author is a free market economist, a physician and a senior fellow at the Manhattan Institute. This book has been endorsed by Milton Friedman so should be of appeal to free market advocates.

Dr. Gratzer persuasively argues that the fundamental problem with U.S. health care is too much government regulation. To argue this, Dr. Gratzer first notes how the employer-based health coverage arose as an unintended side effect of a tax law, which allowed employers to write off health care expenditures for their employees. Moreover, Dr. Gratzer argues that both Democrats and Republicans have both essentially offered more government regulation as the solution to health care, which has not worked. The Democrats, such as the LBJ Administration, promoted enormously inefficient programs such as Medicare and Medicaid. The Republicans, have promoted bureaucratic HMOs, which have led to similar large-scale inefficiencies.

Driving this point further, Dr. Gratzer greatly details the harmful economic consequences of government regulations in health care. For example, the Emergency Medical Treatment and Active Labor Act (EMTALA) forbids hospitals from denying any patient for emergency care. The economic reality is that this leads to hospitals suffering economic losses by being forced to treat patients, regardless of if they can pay for the care, which ultimately leads to the closing of hospitals. Furthermore, insurance mandates, such as benefit mandates, rating mandates and bans on out-of-state insurance, restrict competition and lead to higher insurance premiums. Dr. Gratzer also thorough analyzes the harmful economic consequences of the FDA, Medicare, Medicaid and much more.

This book also dispels many common myths about the quality of U.S. health care. For example, statistics are often cited to argue that Canadians and/or Europeans have higher life expectancies than U.S. citizens. Dr. Gratzer argues that such studies mistakenly compare statistics on *health* when they should be on *health care*. There numerous lifestyle habits that differ between cultures, such as frequency of exercise and diet, which effect health. Dr. Gratzer proposes examining statistics on cardiac arrest patients, to see which country offers better treatment. In these respects, Dr. Gratzer argues that the U.S. system is clearly superior to its universal health care counterparts.

As one can infer, Dr. Gratzer proposes free market solutions to fix American health care. Specifically, he proposes drastically reducing the various regulatory excesses that he delineates throughout his book as well as embracing Health Savings Accounts. As always, Dr. Gratzer corroborates his arguments with real-world success stories, such as the success of Whole Foods' adoption of HSAs for its employees.

I highly recommend this book to all fans of free market capitalism with an interest in health care policy.
John B. Sullivan, Jr., MD  Feb 3, 2008
The whole premise of this book is a fallacy. Health care is not a market driven phenonmenon. Capitalism as the author refers to is basically those with lots of money get quality health care, those without lots of money get something of much lesser quality. He ignores trauma as a major cost of health care and the fact is trauma victims don't usually make the choice to be traumatized. Also, 50% of trauma victims have alcohol in their system and he makes no effort to bring back prohibition as a cost saving feature of health care. The reason health care costs go up instead of down is due to illness, age, lack of preventive health, and good old American freedom to eat at any McDonald's you wish and smoke as much as you like. A person having a heart attack will not stop to consider how to best spend his limited health care dollars in our market economy. He wants help now. He wants the latest and best drugs, an excellent cath lab and great cardiologists whose hospital has the lowest mortality. If the man has no money or no insurance, he could have a bill of $100,000 in two or three days that is the equivalent of another home mortgage. But this is capitalism, so his wages will be garnered and his home sold to pay the bills. He should have gone to the cheaper hospital, wherever that is and also should have taken the cheaper ambulance Maybe he should have walked to save money for the $1.2 trillion health care system and demonstrated that he too is a good capitalist like the author of the book. Save your money and read Health Affairs, its a reliable, peer-reviewed publication on health care policy and financing.
The perfect antidote to Moore's Sicko propaganda  Sep 17, 2007
Let me state now that NO ONE is denying that healthcare in the United States is messed up right now, and is facing some SERIOUS issues. Even the most conservative Republican knows this full well and good. This is not even the issue. The real issue should be: would socializing things make our problems better or worse?

Michael Moore, in Sicko, touts Canada's socialized healthcare system, even calling it "free." (It's not free. The government also does not "pay" for it because the government does NOT have any money. Taxpayers pay for it.) Moore is of course conveniently ignoring many well-known facts. The author of Cure was a Doctor in Canada, and saw first-hand the problem with socialized medicine. His book demonstrates that it's not all that it's cracked up to be. Sorry Hillary.

In England and Canada, if you go to the doctor or the hospital, you won't get a bill. Yeah that's great. But the problem that has emerged is that it takes SO LONG to even get in for certain types of treatment that people are DYING OF EASILY TREATABLE ILLNESSES THERE. In England this has gotten SO BAD that more people are dying a year of treatable cancer than from automobile accidents!!! Yes, that's right. The cancer WAS treatable, but by the time they actually get in for treatment, it has advanced to the stage that it no longer is treatable, and the patient dies.

So, if the healthcare in Canada is SO WONDERFUL, then why are so many Canadians flooding our Northern hospitals every year? They come across the border for an appointment they can get right away, when in their own country they would have to wait nine months to a year for treatment. As shown on 20/20, dogs and cats that need surgery in Canada get it faster than humans!

By the way, if you get strep throat and have to wait a month to even get in to see a general practitioner (which is about the typical wait for GPs in Canada), then what's even the point? You'll be better by the time you get in! So, depending on whether what you have is life-threatening or not, YOU'LL MAY EITHER BE BETTER OR UNCURABLE BY THE TIME YOU EVEN SEE A DOCTOR! Who cares if it's "free"? As the Canadian woman on the September 14th episode of 20/20 said who had to come to America for a life-saving surgery that the Canadian system classified as "elective surgery" (whereas the American doctor gave her only a couple weeks to live), "Who cares if they make a profit (in America), I'm alive!"

The wait to see dentists in England is so bad that people are now performing home dentistry. We're not talking teeth cleaning here, but people pulling their own teeth out instead of having professional work done! Lines to get into the dentist in England look like the lines did at the local theater on the opening night of Star Wars Episode III. No thank you!

By the way, if the government-run medical system in Canada is so great, then why does a private clinic now open in Canada EVERY WEEK, on average, even though such clinics ARE ILLEGAL? Furthermore, if these private clinics are illegal in Canada (and they are), then why does the Canadian government do nothing to stop them? BECAUSE THE CANADIAN GOVERNMENT KNOWS IT NEEDS THEM, THAT ITS HEALTHCARE SYSTEM IS CRUMBLING, THAT'S WHY. The prime minister of Canada recently suggested that their socialized healthcare system is on the brink of collapse, and Americans are scurrying to emulate it!

This book is a much-needed reality check after the overlong season of uncritical love surrounding Moore's obscurantist propaganda documentary. In fact, it's too bad this book isn't a documentary itself; it could then act as a more effective counterweight.
Evidence versus anecdotes  Aug 9, 2007
David Gratzer, being a licensed physician in Canada and the US, is a credible critic of proponents of socialized medicine. He does an excellent job of providing data to support his points, and most of his points are that people supporting the concept of a single payer for health care use anecdotes rather than convincing data to show how the US health system is failing. He uses hard endpoint data, such as diagnosis of breast cancer in early stages, cancer survival data, and survival after heart attacks, to show that health care in the US leads other countries in the world and espcially those with single payer systems run by the government. He makes the point that being "politically correct" doesn't necessarily make one "scientifically correct". The way he criticizes the mind-set of socialized medicine reminded me of the methods used by Thomas Sowell in his 1995 book, "The Vision of the Anointed". He pointed out that most of the "policially correct" set ignore factual evidence. Gratzer finds these arguments and provides the evidence that is often ignored. This should be a must read for those in positions to influence the debate.

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