Book Publishers

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• Richard L. Reece, MD

  January 4, 2011 at 4:04 pm

  What: Book Proposal: Health Reform Handbook

  To: Health Reform Book Publishers

  To Whom It May Concern:

  I would like you to consider finding a publisher for Health Reform Handbook.

  I believe the health reform law, the Patient Protection and Accountability Act (PPACA) will be at the center of the national news for the next two years, as Congress debates whether to implement it as is or repeal it.

  The American people will want to know – What’s at stake here? How will it affect me? What do doctors think about it? Will they be there when I need them?

  My book, 68,000 words long, is made up of 106 blogs, each about 6000 words, that I have written about health reform and innovation over the last nine months at Medinnovation blog. The title page of the book, my background, its contents, and its foreword are as follows.

  I am a well-known author on health reform. My latest two books are Obama, Doctors, and Health Reform (IUniverse.com, 2009) and Innovation-Driven Health Care (Jones and Bartlett, 2007), My posts have appeared frequently in kevind.com, Healthcareblog.com, and Healthleadersmedia.com.

  1) Title Page:

  Good Intentions:
  Health Reform Handbook
  One Hundred and Six Blogs on Patient Protection and Accountability Act (PPACA)

  By Richard L. Reece, MD

  2) My Background

  Richard L. Reece, MD, is former Editor in Chief of Minnesota Medicine and Physician Practice Options. He is author of 9 books on the health care system, including Innovation-Driven Health Care: 34 Key Innovations, and more recently, Obama, Doctors, and Health Reform. In the latter, he explores what physician mindsets, patient concerns, the U.S. culture, and our system’s complexities portend for reform. Dr. Reece works closely with The Physicians Foundation, a nonprofit philanthropic organization which represents 800,000 physicians in state medical societies. For the last four years he has written a blog, medinnovationblog.blogspot.com. It has 1600 entries on health care innovation and reform. He also has a website, http://www.DoctorReece.com, and is on Twitter.

  3) Contents

  Part One – Health Reform and the American Culture
  1. Tipping Point
  2. Perfect Reform Storm
  3. U.S. Exceptionalism
  4. American Heritage
  5. Reform and Repeal Odds
  6. Massachusetts and Indiana Experiments
  7. Romney’s Legacy
  8. Center Right Nation
  9. Americans and Their Medical Machines

  Part Two – Patient Protection and Accountability Care Act
  10. “Fiendishly Complicated”
  11. Winners and Losers
  12. Vast Law, Half-Vast Consequences
  13. Positives and Negatives
  14. Checks and Balances
  15. Correctness and Incorrectness
  16. Wisdom of Crowds
  17. Constitutionality
  18. If Unconstitutional, Then What?
  19. Law Tells No Story
  20. Big Brother and the Rest of Us
  21. Listening to Voters
  22. Collectivism of Elites Vs. Collective Wisdom of People
  23. Health Repeal Future
  24. Conflicts Between Washington and the States
  25. Obamacare’s Death Greatly Exaggerated

  Part Three – Reform Costs and Demands
  26. The Big “D”
  27. Everything Has a Price
  28. It Ain’t the System, It’s Aging
  29. Doing the Math
  30. Health Costs and Human Nature
  31. SNAFU (Situation Normal All Funds Up)
  32. Hospital “Facility Fees”

  Part Four – Physician Related Blogs
  33. Stalking the Non-Compliant Physician
  34. Physicians’ Manifesto
  35. Obamacare Crunch
  36. Physician Gratitude List
  37. Texas Tort Reform Benefits
  38. Congress Hoisted on Its Own Petard
  39. Who Speaks for Physicians?
  40. A Remarkable Document
  41. Primary Care in the Dumps
  42. Scuttlebutt
  43. Monstrous Developments
  44. Physician Sentiment Index
  45. Doctors Dilemmas
  46. The Future Ain’t What It Used to Be
  47. Feminization of Medicine
  48. M.D. or Not To Be?

  Part Five – Electronic Health Records

  49. Bonanza or Boondoggle
  50. “Inevitability” and “Waiting Game”
  51. Is “Free’ EHR for Real?
  52. Unnatural Communications
  53. Talking to Your EHR
  54. Patients May Lie if Privacy Threatened
  55. Need for Physician Useful Information
  56. Hospitals and Doctors Not Walking the EHR Line

  Part Six – Access to Doctors
  57. Playing the Percentages
  58. Will Doctors Be There?
  59. The Access Mess
  60. Who Will Care for the Sick?
  61. I Told You So

  Part Seven – Patients
  62. Resuscitation of Death Panels
  63. “I Feel Like a Million Dollars!”
  64. Patient-Centered Care
  65. Heart Disease and Health Reform
  66. More Private, Personal, and Decentralized Care
  67. A Physical Exam Tale

  Part Eight – Medicare
  68. Ba-Ba-Ba-Ba-Boom! Boomers turn 65
  69. 65.Medicare Auditor’s Report
  70. Fraud, Abuse, and Over-Use
  71. Seniors Skeptical

  Part Nine – Government and the Two B’s (Bureaucracy and Berwick)
  72. Res Ipsa Loquitur
  73. Growing Bureaucracy
  74. Where Has Trust in Government Gone?
  75. Sickness of Government
  76. Berwick Quote
  77. Berwick in His Own Words
  78. Harvard-Driven Health Care
  79. Berwick, Medicare, and Medicaid

  Part Ten – Innovations
  80. Innovation – Last Great Hope
  81. Irresistible Force
  82. Why Not More Innovation?
  83. Balancing Reform and Innovation
  84. Top Ten Innovators
  85. Getting Your Care at Work
  86. No Miracles Among Friends
  87. How To’s of Medical Innovation

  Part Eleven – Unintended Consequences
  88. Waivering and Wiggling Out of Reform
  89. Incoming Waves of Consolidation
  90. Holes You Can Drive a Truck Through
  91. Dislocations
  92. Obsolete Agents

  Part Twelve – Physicians and Hospitals
  93. Chain-Linked Reaction
  94. Hospital Doctor Hiring
  95. Disgruntled Hospitals and Unhappy Hospitals
  96. Will Bundled Billing Save a Bundle?
  97. A Private Practice Killer
  98. Resolving Hospital Physician Conflicts

  Part Thirteen – The Internet and Social Media
  99. How Tweet It Is
  100. It’s Internet and Social Media Time
  101. Computer is Moron

  Part Fourteen – Miscellany
  102. Grace Marie Turner and the Galen Institute
  103. The Biggest Elephant in the Room
  104. Too Many Rocks in Physicians’ Knapsacks
  105. Why the Political Sea is Boiling Hot, and Pigs Have Wings
  106. The Pruning of Reform Christmas Tree and Santa’s Castration

  Foreword

  As 2011 dawns and Republicans take control of the House and reach a filibuster-proof minority in the Senate, the American health system has reached a tipping point.

  Sometime this year government will pay for 50% of private expenditures for health care in America. If the health reform law goes into full effect in 2014, this percentage may grow to perhaps 70% to 90%, as in other nations. If that occurs, the Federal Piper will call the tune, tipping the health system towards government control.

  This book is one physician’s view of the political and practice environment culminating in the tipping point. The book contains one hundred and six selected blogs from among the 1600 I have written over the last four years on my Medinnovation blog. The blogs appearing here were published from March 23, 2010, when the Accountable Care Act passed, to January 3, 2011, when new members of Congress were inducted.

  The blogs average 600 words in length. They are not intended to be comprehensive, or to be read sequentially, or to have any single dominant theme., other than to discuss consequences of the health reform law. Instead these blogs are snapshots of current reform and future reform consequences, many unintended.

  What will happen between now and 2014, when the health reform law is slated to take full effect, is anybody’s guess. Several things, however, are clear. Costs are rising at an accelerated pace, employers are dropping covering and limiting benefits, and the reform law has not received the expected popularity bounce in the polls. As I write, 52% of Americans oppose it, and 60% believe it ought to be repealed. And the majority of America’s physicians and business owners either oppose the law or remain skeptical, uncertain, or fearful about its consequences.

  The health reform law, the Patient Protection and Accountable Act (PPACA), now called the Accountable Care Act (ACA), or Obamacare for short, has experienced a rocky start. Some dub its passage as an “historic achievement.” Others refer to it as a “monstrosity.”
  The health reform law is a many splintered thing, a product of American diversity, political partisanship, fragmented care, and a search for the right balance between government authority and individual freedoms. These freedoms include the right of doctors and patients to make decisions based on the patient’s best interests.

  These 106 blogs contain redundancies. Of these redundancies, I would simply say: some things are worth repeating and re-emphasizing.
  I have never questioned the honorable intentions of reform backers. But I often wondered if reformers contemplated the consequences.

  Thank you,
  Richard L. Reece, MD
  860-395-1501, rreece1500@aol.com
  Old Saybrook, Connecticut

  January 4, 2011

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