By Christopher Moriates, MD; Vineet Arora, MD, MPP; and Neel Shah, MPP ’04 MD’09
McGraw Hill Education, 2015, $55
“Some physicians and ethicists may warn that the separation of medical care and costs is an important, necessary aspect of the medical profession, ensuring a firewall between clinicians’ medical decisions and their financial incentives. However, this separation is actually relatively new to the profession of medicine. … Even as late as the 1960s, about 50% of healthcare costs in the United States were paid out-of-pocket.”
—from Understanding Value-Based Healthcare
Many of us are quick to blame politicians and insurance executives for the wasteful, inefficient morass that is the US health care system. But Shah and his coauthors argue that true reform can happen only on the front lines—when clinicians offer patients less wasteful, more affordable care that’s delivered fairly, equitably, and safely. Shah is the founder and a leader, with Moriates and Arora, of the nonprofit Costs of Care, which strives to improve the value of health care. They weave succinct, accessible presentations of research and data with case studies and personal essays to provide an overview of the many challenges of the existing system, and they dedicate more than a third of the book to solutions, from medical education to better screening practices to reimbursement reform. “[C]linicians can take the responsibility for helping alleviate this problem,” they write.