I used this blog two weeks ago to preview Emanuel's new book, Reinventing American Healthcare. Such is of much importance to me as I wanted to juxtapose it with my own book, Next Medicine, on the same topic. While Emanuel is inside the tent of political policy creation, I am an observer at distance but am equally concerned.
My earlier blog reflected our shared discomfort with the bungled logistics of the roll out of Obamacare. We both expressed our concern that such an inauspicious launch not obscure the overriding value provided by the expanded access of the new legislation.
At that time I had not yet read the book. Now I have. I guess if I were to be confined to a single-word description it would be "timid." I have been a consistent supporter of a major reinvention involving increased coverage, but I have been concerned with the details of what is to be covered. I believe in my book I was bold. I find Emanuel timid. There is little in his book to indicate a policy change that will affect the cost spiral that all agree is unsustainable. Without serious attention to the financial components of a reinvention it is hard to find support.
In my book I recommend a total conversion of our sickness system to a health system, from a system that focuses on repair to one that insists on prevention. Emanuel's book has four spare pages on prevention and health promotion, which to me are the sine qua non of any meaningful redirection.
The major editorial review of my book cites it for being "wishful." I much prefer this adjective to timid, particularly as we approach 20 percent of our GDP being shoveled down a bottomless black pit. Emanuel's book gives little hope for respite.
Health should be cheaper and is certainly a more noble cause than repair.
Let us stop mopping the floor and turn off the spigot.