Strong Medicine
George C. Halvorson
Random House, New York City
1993, 256 pp., $19 (hard cover)
This well-written text describes — with clarity and precision — the United States healthcare system from the 1960s to the present. In his introduction, George C. Halvorson states that reading the first five or six pages of each chapter will give the reader a synopsis of that section. A reader can then move on to the next chapter if time is short. However, you may find yourself spending more time on the chapters that require more careful reading.
The first six chapters make an excellent reference text for those now entering the healthcare profession in any capacity. These chapters give a historical summary of what has been happening in the healthcare delivery system from the mid-1960s to the late 1980s. Chapter headings give an excellent clue to what is in each chapter. Halvorson depicts very well the practices, beliefs, approaches, and use of technology during these 20 years. He also points out the misuses of our healthcare system and why it has led to an unrealistic vision of what healthcare should be.
Anyone who has been deeply involved in healthcare could probably start reading Strong Medicine at Chapter Seven. Only those who have been living in a cocoon would be unaware of the problems of the 1960s, 1970s and 1980s. These problems include health insurance programs based on risk selection and avoidance; unnecessary, complex, and wasteful healthcare services; "defensive medicine"; a nonsystem approach to care; and a hospital "arms race" based on revenue, not care. These and others mentioned by the author are the root of the present situation.
Chapter Seven presents a clear analysis of current reform proposals and options — defining the positive aspects, as well as potential pitfalls. Chapter Eight presents various solutions and offers 12 major objectives related to healthcare reform. Among the 12 listed are insurance industry reform, universal coverage, and appropriate use of technology. A significant number of team providers of healthcare in many parts of the nation are already implementing many of the solutions and objectives.
Certainly not all providers are at the same point of progress. This book, however, is an excellent reference to be studied at whatever place you find yourself and whatever your opportunities are for implementation.
Sr. St. Joan Willert, CSJ
President/Chief Executive Officer
Carondelet Health Services
Tucson