But note this criticism of McKinnell's ideas:
Little New, Mostly Excuses for High Drug Prices, June 3, 2005
Reviewer: Loyd Eskildson (Phoenix, AZ.) - See all my reviews
McKinnell begins by pointing out that our healthcare system focuses on sickness - containing, avoiding, and shifting the costs of disease. His suggestion (hardly the first one to do so) is that we instead focus on the costs of disease.
To do this, his suggestions include 1)replacing typical health insurance reimbursement with portable "health savings accounts" where those covered would have financial incentives to improve key lifestyle components - eg. exercise, diet, smoking, etc., 2)mandating the use of electronic medication ordering (minimize drug interactions, transcription and dosage errors), 3)"disease management" programs focused on high-expenditure maladies such as diabetes, and take an overall approach to improvement (eg. include lifestyle changes), and 4)specialization of physicians and facilities ("practice makes perfect"). While again, none of these suggestions are new, they are worth repeating.
McKinnell also suggests increasing the supply of healthcare providers - however, the evidence on this is not encouraging - experts have found that a greater concentration of specialists is associated with greater procedure rates - even after taking into account variations in population. He also blames health insurance for the rapid increase in healthcare costs. However, this conclusion is undermined by the fact that despite much lower dental (vs. healthcare) coverage rates, dental costs there have increased MORE than general healthcare costs.
The bulk of the book, however, is devoted to defending the drug industry in general, and Phizer in particular, from charges of overcharging. McKinnell points out that prescription drugs comprised about 10% of healthcare costs 40 years ago and today, that major drug advances have occured in recent decades, and that generic drugs costs LESS in the U.S. than elsewhere. He also defends TV drug ads as helping to improve consume awareness of certain diseases - ignoring the issue of how the information is often seriously biased.
To be fair, however, McKinnell also points out commendable Phizer programs to help African nations and American nations with low incomes to buy drugs. Nonetheless, the overall focus on and bias towards defending drug companies, and the lack of originality (eg. see Leapfrog.org) regarding solutions severely limits the book's value.
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