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Healthcare, Guaranteed: A Simple, Secure Solution for America

Healthcare, Guaranteed: A Simple, Secure Solution for America
By Ezekiel J. Emanuel

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America spends more than any other developed nation on healthcare—$2.1 trillion in 2007 alone. But 47 million Americans remain uninsured, and of those Americans who are insured, many suffer from poor health. In his ground-breaking proposal, Dr. Ezekiel Emanuel offers up a plan to comprehensively restructure the delivery and quality of our healthcare. By eliminating employer-healthcare and establishing an independent program to evaluate healthcare plans and insurance companies, he offers a no-nonsense guide to how government can institute private insurance options that will allow each of us a choice of doctor and plan.

With the rate of healthcare costs rapidly outpacing our gross domestic product, we can no longer afford to maintain our fragmented delivery of care, or entertain reforms that seek to patch, rather than cure, a fractured system. Accessible, straightforward, and revolutionary in its approach, Healthcare, Guaranteed is an inarguable guide to lasting healthcare reform.


Product Details

  • Amazon Sales Rank: #7049 in Books
  • Published on: 2008-05-26
  • Released on: 2008-05-26
  • Original language: English
  • Number of items: 1
  • Binding: Paperback
  • 240 pages

Editorial Reviews

Review

Financial Times
"The best of recent books on this question is happily the shortest and clearest and comes out this month. I think it has the answer. The proposal laid out in Healthcare, Guaranteed by Ezekiel Emanuel ... has convinced me. Whether it will convince others is in doubt for reasons I will come to. But if you are going to read one book on the subject, make it Mr. Emanuel's."


The Spine
“How to Fix Healthcare: Readers may recall an article by Ezekiel Emanuel and Nobel Laureate in Economics Victor Fuchs in TNR a while ago about their truly brilliant and, in my view, ineluctable proposal for paying for basic health care in America. Some time later we alluded in an editorial to the provocation of their plan to all the other policy contortions that pass as the foundations of legislation. Zeke has now expanded this work into a book, Healthcare, Guaranteed, published by PublicAffairs. By the way, he has a PhD in political philosophy from Harvard and an MD from the Harvard Medical School, and is now chairman of the department of bioethics at the National Institutes of Health. Years ago, he started his career as an intern at The New Republic. What a story that would make: those who began right here. In any case, Clive Crook has written a rave review, a truly rave review of the book in Monday's Financial Times. Before you read the review and the book, you should know that at the base of the financial plan is a value-added tax. This is one value-added tax that you might like.”


Newsweek, June 1, 2008
"This Monday a modest little paperback will show up in bookstores offering a suggestion for health-care reform. It won't contain any wrenching human stories like those in last year's big health-care book, Jonathan Cohn's "Sick." It won't be accompanied by gonzo stunts à la Michael Moore's "Sicko." But "Healthcare, Guaranteed," by Dr. Ezekiel Emanuel, may nonetheless be the most exciting book yet to come out of the country's medical crisis. What it offers is a radical yet straightforward proposal, one a layperson can understand. If the complexities of health-care policy give you a headache, this book is aspirin. Read it twice and call your congressman in the morning."


Ezra Klein, American Prospect, August 12, 2008
Healthcare, Guaranteed is beautifully written. It describes many flaws of American healthcare with maddening clarity. Some of its building blocks should be included in anyone’s health plan”


New England Journal of Medicine, August 21, 2008
"Healthcare, Guaranteed is a broad discussion of pervasive problems in our health care system, and it lays out a comprehensive plan to remedy them...Policymakers and all Americans troubled by [the system's] injustices will find Healthcare, Guaranteed a valuable resource for considering solutions to our health care dilemmas."

New York Times, 33: Zeke and book featured in piece about Obama’s health policy team
“Another influential voice at the White House is that of Dr. Ezekiel J. Emanuel, an oncologist and medical ethicist. Dr. Emanuel, a brother of Rahm Emanuel, the White House chief of staff, is working for Mr. Orszag and is sometimes described as the kibitzer-in-chief on health policy….In a book published last year, for example, Dr. Emanuel proposed “a guaranteed health care access plan,” under which all Americans would receive vouchers to enroll in health plans offering a standard package of benefits like those available to members of Congress. The program would be administered by a National Health Board, modeled on the Federal Reserve Board….”

About the Author

Dr. Ezekiel Emanuel is the Chair of the Department of Bioethics at the Clinical Center of the National Institutes of Health and a breast oncologist. A visiting professor at the UCLA, John Hopkins Medical School, and Stanford Medical School, and the author of several books, he lives in Evanston, Illinois.


Customer Reviews

Healthcare Reform, Understood5
If the United States hasn't passed the threshold of interest in health care reform, it must be darn close. Thus, now is the time for a clear and concise argument for any particular approach. Dr. Emanuel puts forward a specific proposal for health care reform that would address the seven goals he views as essential to success. His proposal has a strong appeal to common sense, and as such, it is one that will surely suffer the slings and arrows of outrageous ideologs. But, besides presenting his own distinct proposal for reform, Dr. Emanuel gives enough background on our present plight, along with a heuristic tool to equip us to evaluate the many different reforms out there already and the many yet to come. And, he does this without resorting to the use of extreme case histories, which have become the coin of the realm for authors of books on health care reform and which can have distorting effects on any objective analysis. Even members of Congress will not be able to get away saying they do not understand the concepts in this book.

This is an important book at an important time, and one that invites everyone into the health care reform debate whether they agree with Dr. Emanuel's proposal or not (count me among those who do). But, alas, important as this work is, it would never get Dr. Emanuel tenure at a major research university; it's much too accessible. He'll have to keep his current job.

Another excellent book on the healthcare system in the USA5
Dr. Emanuel has been writing for some time on the subject of health care policy, usually in collaboration with Prof. Victor Fuchs, an eminent, but now-retired, health economist. Prof. Fuchs collaborated with Dr. Emanuel on this book, as Dr. Emanuel notes in it, but apparently the final version as published is mostly the work of Dr. Emanuel.

This and two other books that I highly recommend on health care policy, A Second Opinion and Health Care Policy, are written by physicians who know the science and practice of medicine as well as the economics of medical services. Another, also very good, book, Health Care Half Truths, is co-authored by a physician.

The book is fairly short, very well-written and well-organized. Dr. Emanuel spends the bulk of the book analyzing the current medical services delivery (and to a lesser extent the funding of the system), then at the end of the book makes cogent recommendations on reform.

Although my personal opinion on the particular form that the financing of medical services should take (I strongly favor a single payer/insurer scheme) differs from Dr. Emanuel's view, Dr. Emanuel presents compelling evidence why a single payer/insurer scheme is inferior to his recommendation: a voucher system that is funded by a dedicated value-added tax. Dr. Emanuel recommends the continued existence of private health insurers, asserting that their presence furthers choice and potentially at least engenders competition. My perspective is that private insurance simply has no place in a medical services system. The forces that drive private health insurance companies are immutable. Private insurers inevitably increase the administrative cost of effecting payment for services. They also have no ethical role as deciders of what treatment should occur. In particular very expensive treatments with whatever probability of lengthening a patient's life should not be decided by an employee of a private company. They also will continue to seek to exclude the sick and try to enroll the healthy in their insurance plans. Those are unavoidable characteristics that, at least in my mind, argue for a single payer plan, regardless of the pitfalls that Dr. Emanuel correctly notes.

Read This Book, Back This Plan5
Dr. Emanuel has a smart healthcare solution for what ails us! At the heart of his plan is the method of funding, which makes so much sense. Everyone wants healthcare insurance and everyone should be willing to pay for it. Using a dedicated Value Added Tax (VAT) to pay for vouchers would be progressive, as those with more means consume more. (Credits would be given to those below an income threshold.)

The VAT would capture a fair share from the illegals who currently crowd our emergency rooms for free service; it would also capture significant revenue from the illegal drug trade.

Democrats should want to back it - it is truly universal healthcare. Republicans should want to back it as the plan provides vouchers to afford consumers to choose, i.e., affords competition for efficiency. Companies should want to back it because it removes a huge direct cost and disincentive for employment; workers would benefit for the same reason.

Importantly, the VAT is the tax system of the era of globalization, as it is border adjustable, i.e., subtracted from exports and added to imports. The U.S. alone among its trading partners in not taking advantage of the VAT, which is supported under GATT rules and used by 135 countries today, including all of our trading partners, which get a competitive advantage over U.S. goods and services because of it. (For example, the cost of healthcare for Ford Motor is more than the cost of steel. Imagine subtracting the cost of steel from an exported car, and adding that cost onto an imported car. We would increase U.S. market share!)

I bought a copy of this book for my Congressman, and for a leader in healthcare. Spread the word.