The attachment herein [updated 7 April], more heavily annotated than any I have done before, took 10 years of preparation. I have been working on and off with healthcare issues for a decade. Thanks in part to a slew of gangbuster books that have recently appeared, I have been able to reach some temporary closure. Hence, you will find here my best shot at compassing the healthcare issue as I see it. As I say at the outset in my annotation, this presentation is not about Hillarycare or some such. It is about turf upon which I can claim some expertise—organizational and operational effectiveness. For instance, healthcare financing—except as it causes horrid distortions in priorities, a bias against improving our health—is not dealt with. (By choice.)
I hope that you will “enjoy” this, though most of the story is grim. And I hope that some of you might spend some serious time on the presentation, and give me your feedback. And of course, as always, I hope you will “rob me blind”—and use some of this material in your own work.
Americans mostly think we have the best healthcare in the world, even if the most expensive. In short, that doesn’t fit with the fact that our life expectancy is 45th globally and dropping, that our hospitals unnecessarily kill hundreds of thousands of us each year, and that seeking care at our most prestigious healthcare centers will surely reduce our lifespan compared to care at “St Elsewhere,” as one writer put it.