Why not better and cheaper? Healthcare and innovation

In this compelling and challenging volume, James Rebitzer (Questrom School of Business, Boston Univ.) and Robert Rebitzer (Stanford Univ.) importantly and rightly question the expensive and inefficient health care system in the US. Why not be better and cheaper, they ponder. This question is central to their investigation of the factors that need to align to encourage and create incentives to improve health care financing. Faced with the twin dilemmas of increased spending and high growth in spending, the authors suggest increasing market competition and mobilizing professional and social norms to support needed innovation. Abundant with examples of how health care organizations have experimented with and adopted innovative change, the book describes the many persistent barriers impeding the successful adoption of needed changes. Of particular note is the story of palliative care which harnesses non-financial incentives to spur beneficial change and reinvigorate pride in the medical profession. A huge challenge facing the goal of achieving high-value innovation that lowers costs is the confounding structure of American heath care and its fragmentation. Readers will need basic economic knowledge and a competent understanding of health care management practices to fully follow the authors' arguments in this well-written and densely argued study. Summing Up: Recommended. Advanced undergraduates through faculty; professionals. --Renee R Shield, Brown University (retired)