Affordable Excellence: The Singapore Healthcare Story

Affordable Excellence: The Singapore Healthcare Story

by William A. Haseltine

The Singapore healthcare system produces world-class outcomes at half the cost of Western European countries and less than one-fourth the cost of the United States: Singapore spends 4% of GDP on healthcare; the United States spends 18%.  The World Health Organization ranked Singapore 6th in overall performance; the United States ranked 37th. (See page 200, The World Health Report 2000.)

Looking at costs of specific procedures, ”an angioplasty in the United States is almost $83,000, while in Singapore the cost is about $13,000. A gastric bypass in the United States is almost $70,000, while in Singapore the cost is $15,000. (These figures are in US dollars and include at least one day of hospitalization).”

This book explains how the system works. Continue reading

Healthy Competition

Healthy Competition: What’s Holding Back Health Care and How to Free It

by Michael F. Cannon and Michael D. Tanner

Healthy Competition was published in 2005, but I pulled it off my shelf and reread it in early 2017, in the midst of the discourse about how to “repeal and replace” the Affordable Care Act (ACA, also known as Obamacare). Both the ACA and the proposed replacement focus on insurance, ignoring the exorbitant cost of health care in the United States. In this book, Cato Institute scholars Michael Cannon and Michael Tanner examine how the basic economic principles of price transparency, competition, and consumer choice could lower costs, reduce waste, and increase quality of care. Continue reading

Urgent Care: 10 Cures for America’s Ailing Healthcare System

urgent-care-minda-wilson

Urgent Care: 10 Cures for America’s Ailing Healthcare System

by Minda Wilson, J.D.

As I write this in early 2017, there is much chatter about the potential repeal and replacement of the Patient Protection and Affordable Care Act (ACA) commonly known as Obamacare. I was motivated to read this book to get beyond the myopic hysteria and gain a deeper understanding of the problems and possible solutions presented by healthcare attorney Minda Wilson.

“The United States has the world’s highest [per-capita] healthcare cost, double that of Canada… The number one cause of personal bankruptcy in the United States is due to overbearing healthcare costs… A devastating illness means that, beyond your deductible, you could be responsible for a minimum of 30 percent of the medical bills incurred if you stay in-network. If you go outside of your network, then you could be responsible for between 50 percent and 100 percent of every bill.”

Wilson asks, “Why did the [ACA] focus on providing insurance and not healthcare?” I think this is the fundamental issue. The cost of insurance is a function of the cost of claims. So if the main focus is on subsidizing premiums, the law simply masked the underlying problem rather than solving it. “To be clear, deductibles, copays, and/or the costs of excluded care or limits on care were not included in this measure of affordability.” Continue reading

The 3rd Way

the-3rd-way

The 3rd Way: Building Inclusive Capitalism through Employee Ownership

by Upendra Chivukula and Veny W. Musum

The subject of The 3rd Way sounds intriguing: addressing income inequality by expanding incentives for Employee Stock Ownership Plans (ESOPs) and reforming the corporate tax code. While I think the authors have good intentions, their thesis is flawed. Continue reading

Water 4.0

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Water 4.0: The Past, Present, and Future of the World’s Most Vital Resource

by David Sedlak

David Sedlak is a professor of environmental engineering at the University of California, Berkeley. In this book he explains the history, science, engineering, and political aspects of water and sewer systems. First, it may be helpful to decode the title:

  • Water 1.0—a system of importing and distributing water.
  • Water 2.0—drinking water treatment including filtration and chlorination.
  • Water 3.0—sewage treatment.
  • Water 4.0—next-generation water systems.

I will focus on some of the more contemporary topics in this summary. Continue reading

The Higher Education Bubble

the-higher-education-bubble

The Higher Education Bubble

by Glenn Harlan Reynolds

In the first decade of the new millennium we saw the dot-com bubble and housing bubble end badly. In this concise 48-page booklet, University of Tennessee law professor Glenn Harlan Reynolds explains why higher education will be the next bubble to burst. “Bubbles burst when there are no longer enough excessively optimistic and ignorant folks to fuel them.” Continue reading

The Crime Fighter

The Crime Fighter: How You Can Make Your Community Crime Free

by Jack Maple

Engaging stories from Maple’s career as a detective for the NY Transit Police, deputy commissioner of NYPD, and consultant to Newark, Philadelphia, and New Orleans police departments make this a very interesting read. The fact that the problems and solutions discussed are relevant to other cities—not just NYC—broadens the appeal of this book. While some of the principles will apply to smaller police jurisdictions, the context of all examples is with large cities. Continue reading