Curing Medicare
A Doctor's View on How Our Health Care System Is Failing Older Americans and How We Can Fix It
by Andy Lazris
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Pub Date Jun 14 2016 | Archive Date Jun 14 2016
Cornell University Press | ILR Press
Description
Andy Lazris, MD, is a practicing primary care physician who experiences the effects of Medicare policy on a daily basis. As a result, he believes that the way we care for our elderly has taken a wrong turn and that Medicare is complicit in creating the very problems it seeks to solve. Aging is not a disease to be cured; it is a life stage to be lived. Lazris argues that aggressive treatments cannot change that fact but only get in the way and decrease quality of life. Unfortunately, Medicare's payment structure and rules deprive the elderly of the chance to pursue less aggressive care, which often yields the most humane and effective results. Medicare encourages and will pay more readily for hospitalization than for palliative and home care. It encourages and pays for high-tech assaults on disease rather than for the primary care that can make a real difference in the lives of the elderly.Lazris offers straightforward solutions to ensure Medicare’s solvency through sensible cost-effective plans that do not restrict patient choice or negate the doctor-patient relationship. Using both data and personal stories, he shows how Medicare needs to change in structure and purpose as the population ages, the physician pool becomes more specialized, and new medical technology becomes available. Curing Medicare demonstrates which medical interventions (medicines, tests, procedures) work and which can be harmful in many common conditions in the elderly; the harms and benefits of hospitalization; the current culture of long-term care; and how Medicare often promotes care that is ineffective, expensive, and contrary to what many elderly patients and their families really want.
Advance Praise
"As a medical student, I was trained in 'thorough'—the goal being to find as many problems with my patients as possible. In Curing Medicare, Dr. Andy Lazris seeks to redefine ‘thorough’— and not simply to humanize our profession but to protect the elderly from the harms of too much medical care. It is a passionate but thoughtful critique of medicine's relentless focus on numbers, unimportant measures of performance, and turning people into patients."—H. Gilbert Welch, MD, MPH, Dartmouth Institute for Health Policy and Clinical Practice, author of Overdiagnosed: Making People Sick in the Pursuit of Health
"Curing Medicare is at once serious and wise, humorous and entertaining. There are not many writers who can weave concrete and meaningful data into a book that reads like a juicy suspense flick. Dr. Andy Lazris has skillfully woven data, experience from his medical practice, and real-life patient stories we can all relate to into a call to action to change our broken Medicare system and improve patient quality of life. This riveting book shows Lazris to be a stand-out thought leader in an arena that affects us all: Medicare, over-care, and the disconnect from the peaceful beauty that is possible in the context of aging and death when we don't clutter up the process with end-of-life heroics. Lazris is a fierce advocate for his patients and for educating health professionals and health consumers alike of the dangers of overtesting and overtreating."—Bridget Hughes, MAc, LAc, author of Unlocking the Heart of Healing
"I recommend Curing Medicare for all patients, politicians, physicians, nurses, and health policy thinkers. This is an important book by a very skilled individual. Somehow Dr. Andy Lazris effectively transforms his frustrations with the Medicare system into wonderfully clear teaching stories and solid policy recommendations."—Robert M. Duggan, author of Breaking the Iron Triangle: Reducing Health-Care Costs in Corporate America
"Curing Medicare is a trenchant analysis of the ills of the current health care regime for the elderly. Dr. Andy Lazris's message is a timeless one: you're not sick. You're just getting older. It is not, after all, an unusual condition in the scope of human history. Throughout he warns of the perils of too much, too much surgery, too much medicine, and too high an expectation for eternal youth. It’s a page-turner."—Phillip Soergel, Chairman and Professor, Department of History, University of Maryland, College Park
"Dr. Andy Lazris, a general internist and geriatrician, has written a wise book. All doctors in training and doctors in practice should read it, and so should their patients. Our health system has been slowly but steadily making it hard to be well. This book is well written, well researched, and makes a strong case that less is more for many of the common conditions and maladies that bring people to doctors. Organized medicine and academic medicine makes much of evidence-based practice. But what happens when the evidence is weak? Read this book and judge for yourself."—Daniel Becker, MD, MPH, Director of the Center for Biomedical Ethics and Humanities and Tussi and John Kluge Professor of Palliative Medicine, University of Virginia Medical Center
Available Editions
| EDITION | Other Format |
| ISBN | 9781501702778 |
| PRICE | $24.95 (USD) |
Links
Featured Reviews
Margaret H, Reviewer
Nice explanation of the Medicare system. As a health care provider I can attest to the overwhelming fraud and abuse of the system. The author makes excellent, valid points regarding care for the elderly. Unfortunately, in these times it becomes more about not getting sued than what is ultimately best for the patient.
Elyse W, Reviewer
I couldn't believe how ENGAGING ....and ENJOYABLE .....this book was to read! I actually had a dream which woke me up -- vivid as can be -- which I knew instantly came from reading this book.
I don't even know where to start with this review...because first I want to share my emotions--and how much this book 'calmed' me personally about something personal which has begun to occupy my thoughts. Without writing a long story about my own personal history with medical doctors, testing, an autoimmune disease, and the post 'somewhat' traumatic 'exhaustion' from having come through 5 surgeries between my husband and I, just this past year...
( and we are both healthy), I wasn't looking forward to facing the Medicare process. In 2 more years I'll be consider part of the Medicare-Community...( for lack of a better term). I've had friends --( SMART CAPABLE FRIENDS)-- older than me tell me nightmare stories about just trying to figure out how to JOIN THE CLUB! ha! It's very confusing.
Please forgive me for taking so long to 'review' the book...
but I must share one more VERY IMPORTANT WAKE UP Realization....( for me), that I uncovered reading this.
Not ONLY do I have good medical coverage - ( good old fashion western medicine)...but when my autoimmune disease was at its worse a few years back...I spent money OUT OF POCKET ... ( thousands and thousands of dollars over a 2 year period)...seeing FUNCTIONAL MEDICAL DOCTOR. These type of doctors are KIND... SWEET... Spend 2 hours with you - order very fancy expensive tests - which get sent to SPECIAL labs ...( looking for more accurate lab ranges than western medicine... Base on HEALTH & VITALITY... not on DISEASE). The idea is they look for POTENTIAL PROBLEMS BEFORE A FULL BLOWN DISEASE DEVELOPS. Sounds, good, right? I thought so, too....
BUT.....here is what DOESN'T feel good. These doctors are 'still' looking for things wrong in the body. They say the purpose is treating the root cause, and treating the WHOLE person.....
BUT....after following everything BY THE BOOKS... ( hundreds of foods I was supposedly to removed from my diet including TONS of raw fresh veggies), lots of expensive supplements to buy, my MAIN problem never improved. It was only a few years later with a medical doctor in SF - who knew what I was born with ( it's rare)... helped me. ( gave me a cocktail of medicine which seems to be working). Best help to date!
Point is: BOTH NATURAL DOCTORS....and MEDICAL DOCTORS often COME FROM looking for what's wrong. People go home and worry if they have high blood pressure, for example...( but maybe they don't need to be as concern as they think)
But I tell you --- after reading this book -- I frickin swear to god... It's CRAZY!!!!!!
Worry does not help with the quality of life!!!
Alright, moving on.....
This author, Andy Lazris, is MORE THAN QUALIFIED TO have written this book. He has been a primary care geriatric physician for many years. I love this guy! TRUE....we don't need to be worried about annual mammograms at 90 years of age.... do we? Family members bring their 90 year old mothers to the doctor expecting 'tests'. Always more 'something'. We over test people in this county. We ought to be taking the minimalist approach --- ( doctors ought step away from their rigid training and guidelines), and see how they can guide their patients to enjoy the rest of their live). Lazris says we've been too excessive with specialization. He says we need more 'primary' care doctors and LESS specialists. His argument makes sense ..( completely backwards from what I once thought). The argument is ... why see a primary doctor who only knows a little about a lot of things, when you can see a specialist for a needed problem? One HUGE problem with this is the specialist could find something wrong WITHIN their specialty...( be completely wrong), and they don't look so special anymore. --- The book explains things MUCH BETTER than I. I'm just typing away faster than the speed of light ---( forgive the many typos I'm sure I must have)....
but I got value in this book in a DIFFERENT WAY than I did "Being Moral", by Atul Gawande. This book is an EXCELLENT companion....it goes into specifics - and it has stories. ( I of course love the stories)...but the facts are fascinating as well.
The author explains - better than I can write this review of how Medicare MUST change. I didn't even know how it worked NOW???
Let alone change it....( so I REALLY got a double dose of value from this book and it was personal making the reading a pleasure). He explains about the financing-- where most of the money has been going and changes where we should be spending it. ( re-Organization). He doesn't say it's going to be easy to change the system ... But he DID map out a solution.
One quick warm story... Then I'm out of your hair ( thank you to ANYONE who took the time to read this)... If you didn't read this ...( no problem... this might not be a topic or issue for you)....
Here's just 'one' recap of a story in this book I loved sooo much. ( there are more)
One of Dr. Lazris's patients - an Italian older man who lived in a retirement community made an unusual ACUTE visit. Dr. Lazris asked his front desk staff why he was coming in. The front desk staff didn't know.. but told him that it was urgent. Well, Andy Lazris feared he must have a catastrophic illness. ( this was an elderly man who never complained about anything. But when he arrived he looked terrific. He said:
"Hey, doc", "I've got heart disease, diabetics, high blood pressure, I pee too much from a big prostate, and my balance isn't worth a damn. You can write all that stuff in your note and bill Medicare for it and say we talked about it. But let me tell you why I am really here. I'm taking a Jewish history class at the community college, which is a great class, but there's a lot of confusing things they talk about for a Catholic liked me, and I know you're Jewish, and you like history, so I was wondering if I could run some stuff by you."
"That was the urgent visit! And both of us enjoyed it very much." But after their history less, the doctor did ask him some health questions-his expectations for the rest of his life, his exercise regime and family. Andy said he learned more about him during that visit than in all previous encounters.
Thank you to my friends who took the time to read this. I got much value from this book. I'm less concerned about following rules - doing things right...
Although I 'heard' what this great doctor said: "lack of movement and stress contribute to aging faster than anything else". So... I'll walk - swim- bike -- wiggle & jiggle and be happy!... As for the small stuff - wrinkles, cellulite, loss of muscle mass, dry hair, an older aging body...lucky me....they really are small potatoes!
Thank you Cornell University Press, Netgalley, and Andy Lazris
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