Patient: American health care
Second opinion: One book, in plain language
Published: 2009

Why does America pay the most for health care and get less?

Name: Solving the American Health Care Crisis: Simply Common Sense
Author: Umang Malhotra
ISBN: 9781440180194

Solving the American Health Care Crisis is a plain-language tour of how American health care works, how other rich countries do it differently, and the common-sense fixes Umang Malhotra proposes.

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Front cover of Solving the American Health Care Crisis: Simply Common Sense, by Umang Malhotra

First published 2009.
How to read it today ↓

The cover took America’s vital signs.

Ranks as printed on the book’s cover in 2009, a snapshot of that time rather than today’s data.

1 in obesity
27 in life expectancy
37 in infant mortality
54 in access to health care
…despite spending twice what the next rich country spends per person.

The book calls these myths.

Six things Americans hear about their health care. Read each claim, then get a second opinion from the author.

Second opinion

Says who?

“That claim is hard to support when America spends over 16% of its gross domestic product (GDP) on health care, while more than 47 million Americans have no health insurance and millions more are under-insured.”

Author’s summary, 2007 figures

Each statement comes from the author’s own list of “myths and misconceptions.” The red margin notes are ours; the answers are the author’s own words, unless marked otherwise. Get the full case in the book on Amazon (opens in a new tab)

Three ways to pay. Pick one.

“There are only three possibilities on which a universal health care system can be based,” the author writes. Choose one, then see where he lands.

Option 1 Privately funded Option 2 Private and public funding combined Option 3 Publicly funded only

Pick one to see what the author says.

Compare. Diagnose. Prescribe.

The book walks the whole system in three moves. Topics below are from the author’s 2007 summary; the published book updates them. See the real table of contents on Google Books (opens in a new tab)

Compare How others do it

How Japan, Australia, Canada and Europe’s rich nations pay for care
What America spends, and what it gets back
Massachusetts and California: two early state experiments

Diagnose What goes wrong here

Bureaucracy and paperwork
Fragmentation
The prescription drug program
Drug advertising
Lobbyists
Health insurance policies
Malpractice and defensive medicine
Long-term care, emergency rooms and medical mistakes
Myths and misconceptions

Prescribe What could work

A commission of “people of integrity and character”
Care based on need, plus “top-up” insurance
An electronic medical card for every resident
Prevention and regular check-ups
Information technology to cut paperwork
Medical tourism

Start reading.

The fundamental premise of Solving the American Health Care Crisis is that most American decision makers are in a state of denial. Many of them consistently claim that the United States has the greatest health care system in the world.

Per dollar, America spends much more and gets much less in return, than other affluent Western nations do, when it comes to health care spending.

From the author’s summary of the book, written in 2007, before publication.

Read the full summary Preview the preface on Google Books (opens in a new tab)

Questions the book asks

Why is it not possible for the richest and most powerful country in the world, with the finest brains and institutions, to devise a universal health care system that is simple and cost effective?
Is an ideology more important than the physical security of an individual?
Why can’t America learn from some of the best practices of health care systems in other rich countries, and create an even better system?

“…overall the book is an enlightening read.”

“Offers plenty of evidence to back up one of our time’s most contentious debates.”

Kirkus Discoveries, March 1, 2010

“As a nation, we have been in a total state of denial about the complexity of our health care crisis. Mr. Malhotra dissects the problem with the precision of a surgeon, and exposes the issues and the alternatives with compelling logic. It’s an inspiring call to action.”

Reviewed by Dan Ruchman President, Ruchman & Associates

“Malhotra asks tough questions about what’s happening to the American health care system. His answers are eye-opening and sensible... a must read for everyone concerned about their health and the future of America.”

Reviewed by Christopher Scott, PhD CEO, Next2Eden.com

“This makes the optimization of American’s health care refreshingly clear, simple, and efficient.”

Reviewed by Dr Sunita Shailam, MD Sun Health Medical Clinic, Inc. Medical Director

Reviews first published around the book’s release (2009–2010). Read all the reviews

Reading it today.

The book was published on November 23, 2009, a few months before the Affordable Care Act became law in March 2010. Its figures come from the years before publication; Kirkus noted that most date from 2005 and before. Read the numbers as a snapshot of that era.

What the book offers today is the explanation: how the American system is pieced together, how other rich countries pay for care differently, and the plain questions it asks about both.

An outsider’s view, from nearly 80 countries.

Author: Umang Malhotra
Trained in: London, Stockholm, economics
Field: International business, not medicine

Umang Malhotra earned degrees from London University, joined the Royal Institute of Technology in Stockholm for his PhD, and later studied economics. He built a career in international business and has travelled to nearly 80 countries. That outside view is what lets him hold America’s system up against the rest of the rich world.

About the author