Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System

HR Hero Line editor Wendi Watts reviews the book “Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System” by Phil Bredesen.

I first became interested in Tennessee Governor Phil Bredesen’s book Fresh Medicine: How to Fix Reform and Build a Sustainable Health Care System after reading an op-ed piece he wrote in the Wall Street Journal. In it, he goes through the math of how much Tennessee would save under the new federal health care reform plan if the state dropped its existing health care plan for core employees and  increased their pay to make up for the loss of insurance — the grand total is $146 million annually. Yes, annually.

And that’s only for about 40,000 core state employees. There are 128,000 employees in local Tennessee school systems and another 110,000 local government employees. When you add those workers in, the hypothetical savings are simply mind-boggling.

Whether you like the health care reform package passed by Congress this year, think it went too far,  don’t think it went far enough, or are just confused, most people agree that U.S. health care is in bad health. And health care is increasingly becoming a huge expenditure for employers that they are finding it harder and harder to afford.

Most of what we’ve heard about health care and reform are sound bites designed to support the desired outcome of whatever group or person is speaking. Basically, I think it’s a lot of yelling and oversimplifying while most Americans are either struggling to get or pay for health care or are afraid of losing the coverage they have.  Meanwhile, employers are having to make wild guesses about what parts of health care reform they need to be preparing for and which ones may be changed.

Into all of this confusion steps Bredesen with his first book. A politician trying to tackle this big, hairy mess of an issue in 247 pages is either brave or crazy. After reading the book, I think many of his ideas are braver than crazy. But I haven’t drunk the Kool-Aid yet.

Two things are very obvious from reading Bredesen’s book. One, he earned a bachelor’s degree in physics from Harvard and thinks like a scientist. Second, he is the former CEO of a managed-care company and presents health insurance organizations in a kinder light than most other players in the health care industry.

Bredesen offers what he calls six “stepping stones” to fix health care reform and build a sustainable system that will pay for itself. The first step is to make health care fair and preserve patients’ dignity. Second, understand exactly why health care is expensive. Third, manage the hypercomplexity of a massive health care system. Fourth, improve the quality of care by creating evidence-based standards and measuring providers’ quality. Fifth, use what Bredesen calls integrated systems of care to organize and provide health care services. Finally, the sixth step is to change how we fund health care.

This book isn’t the cookie-cutter, politically correct, party-line-following long press release that we have become accustomed to seeing from politicians as they seek higher office or re-election. It steps on a lot of toes. It doesn’t speak down to the reader — you’re expected to  grasp some higher scientific and business management concepts.

For anyone who is interested in a serious discussion of health care reform and a spirited, reasoned debate based on science and logic — not political pandering — this book is worth reading.

I can’t resist adding a mention of my favorite line in the book because you really don’t expect the physics major/Yankee governor of a Southern state to provide laugh-out-loud moments in a book on health care. In the chapter in which he describes hypercomplex systems and how they organize and manage themselves, he uses two examples to explain those sorts of systems — the free-market economy and evolution.  Before he starts his explanation, he says, “If you’re either a communist or a creationist, you might want to skip to the next chapter.” While touting the free-market economy doesn’t take any guts for a politician today, using evolution as an example in a valid system is very brave.

Wendi Watts is the Web content specialist at M. Lee Smith Publishers and editor of HR Hero Line. Before moving to the online world at HRHero.com, Wendi worked as an editor for the state Employment Law Letters. She has worked as an editorial assistant for the IT Division at Middle Tennessee State University, was the school and community liaison for Rutherford County Schools in Murfreesboro, Tennessee, and was a journalist at two Middle Tennessee newspapers.