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Who Killed Health Care? America's $2 Trillion Medical Problem—And the Consumer-Driven Cure

By Regina E. Herzlinger
McGraw Hill 2007 ISBN: 9780071487801

About the Book

One of the nation's most respected health care analysts, Regina Herzlinger exposes the motives and methods of those who have crippled America's health care system—figures in the insurance, hospital, employment, governmental, and academic sectors. She proves how our current system, which is organized around payers and providers rather than the needs of its users, is dangerously eroding patient welfare and is pushing costs out of the reach of millions.

Who Killed Health Care? then outlines Herzlinger's bold new plan for a consumer-driven system that will deliver affordable high-quality care to everyone. By putting insurance money in the hands of patients. removing the middleman in the doctor-patient relationship, and giving employers cost relief, consumers and physicians will be empowered to make the system work the way it should. Herzlinger describes in precise detail how her innovative program will provide.

  • Smaller, disease-focused medical facilities that provide complete care to patients
  • A national system of medical records that provides privacy to provides and allows for confidential access to approved practitioners
  • Mandatory performance evaluations of all hospitals and all other medical organizations
  • Mandatory health insurance with subsidies for those who cannot afford it

Who Killed Health Care? is a call to arms that must be answered; the welfare of every American hangs in the balance.

About the Author

Regina E. Herzlinger, often referred to as the "Godmother of Consumer-Driven Health Care," is a Senior Fellow at the Manhattan Institute for Policy Research. She was the first woman to be tenured at the Harvard Business School as the Nancy R. McPherson Professor of Business Administration. Herzlinger is widely recognized for her innovative research in health care, including her early predictions of the unraveling of managed care and the rise of consumer-driven health care and health care focused factories—two terms that she coined.

Professor Herzlinger has been honored with numerous awards, including the American College of Healthcare Executives' Thompson Book of the Year Award twice and the Academy of Healthcare Executives Research Award three times. She received the Hospital Financial Managers Association’s Board of Directors award and has been repeatedly selected one of the "100 Most Powerful People in Healthcare" in Modern Healthcare.

Professor Herzlinger’s authority on health care was solidified by the success of her previous books: in Market-Driven Health Care, she addressed the need to reform the way health care is supplied; in Consumer-Driven Health Care, she reviewed the way health insurance is supplied; and, finally, in Who Killed Health Care?, Professor Herzlinger issues a call to arms to revolutionize our health care system with a consumer-driven cure.



Universal health insurance that's not under government control by Regina Herzlinger, Washington Examiner, July 27, 2007

How shameful that more than 40 million people in this great country—the wealthiest in the world—lack health insurance. The uninsured not only suffer from poorer health, but are all too often mistreated when they do seek hospital care: either charged bankrupting prices or tossed out. Does it make economic sense to provide coverage for tens of millions of uninsured? Critics say that we need at least $50 billion to subsidize those who cannot afford health insurance, and that universal health care will lead to a socialist, government-run health care system. But these criticisms misunderstand both the economics and administration of universal health care. Yes, it must be funded by taxes, which we pay primarily to help the less fortunate. But as Switzerland demonstrates, universal health care can be managed by private health insurers and providers...

Individual Freedom vs. Government Control by Tom Coburn & Regina Herzlinger, National Review Online, 8-1-07

Who Killed U.S. Medicine? by Regina E. Herzlinger, The Washington Post, July 29, 2007 (This piece has also be reprinted in The Sacramento Bee, 07-26-07, The Allentown Morning Call, 07-26-07, The China Post, 07-28-07, The Argus, 07-29-07, The Deseret Morning News, 07-29-07, The Oakland Tribune, 07-29-07, The Alameda Times Star, 07-29-07, and The Center Daily Times, 07-29-07).

America's physicians are the most trusted and valuable resources in our health-care system. Yet doctors' professionalism and incomes have taken a terrible beating recently. The American Medical Association, which received $286 million in revenue last year to protect the profession, has served physicians poorly. Physician incomes, when adjusted for inflation, declined 7 percent from 1995 to 2003, while those of professional and technical workers rose. But unlike other professionals—lawyers, architects, authors and economists—doctors' work is dictated by the policies of insurers and governments...

Where Are the Innovators in Health Care? by Regina E. Herzlinger, Wall Street Journal, July 19, 2007

No sector of our economy is more in need of innovation than health care, yet its many regulations handcuff entrepreneurs. A consumer-driven health-care system will unlock these shackles to bring about a much-needed entrepreneurial revolution... In almost every sector of our economy, brilliant, effective innovators have forced sluggish U.S. industries to become more productive. Sam Walton's exquisitely detailed supply chain management, coupled with his daring decision to locate Wal-Marts in rural areas, kick-started the boom in retailing, while Bill Gates, Steve Jobs and Michael Dell drove productivity in the IT sector. These entrepreneurs, and so many others, have fundamentally improved our economy... But can you name any innovators in our bloated, inefficient health-care system?...


Health Reform—Now Or Later? Investor's Business Daily, Editorial, September 19, 2007

Once the former first lady—who in 1993 failed spectacularly in her attempt to nationalize the massive health care sector of the economy— unveiled a new plan, the issue was bound to zoom to the front of public discourse... Harvard Business School professor Regina Herzlinger, author of "Who Killed Health Care?," which calls for consumer-based, market-oriented reform, told Investor's Business Daily that the costs of Clinton's new plan likely would reduce private-sector jobs and increase outsourcing and other cost-saving measures by businesses...

Hillary Health Care II, Ronald Bailey, Reason, September 19, 20077

Clinton's plan maintains the employer-based insurance system by mandating that large employers continue to buy health insurance for their workers. As Harvard business school professor Regina Herzlinger notes, such a mandate is indistinguishable from a payroll tax... Herzlinger points out that if they are required to pay an additional $5,000 for health insurance for a clerk earning $22,000, the companies will immediately start substituting capital for labor. In other words, economically vulnerable clerks would be fired...

Options key to reforming health care, Guy Boulton, Milwaukee Journal-Sentinel, September 8, 2007

She backs universal health care. She can be trenchant in her criticism of hospitals, health insurers and pharmaceutical companies. And she derides the notion that health savings accounts alone can transform the health care system. Yet Regina Herzlinger also is one of the most influential proponents of using the market to reform the health care system... Herzlinger contends that by creating the right framework, the market can make the health care system more efficient and more humane. The key will be giving consumers more choices...

If Thompson campaign flops, Gingrich will consider jumping in race, Robert Novak, Chicago Sun-Times, July 1, 2007

Sen. Hillary Clinton recently conferred with conservative health-care analyst Regina Herzlinger, who advocates universal health insurance provided by the private sector and who has sharply criticized the 1994 "Hillarycare" as Clinton's "bid for a centrally controlled system.: Herzlinger, a Harvard Business School professor, was one of several health-care experts heard by Clinton during a two-hour "listening" conference call...

Statewide insurer extends its investment, influence, Daniel Axelrod, Scranton Times Tribune, July 1, 2007

"Yes, it's easier to have one big company that deals with everyone in Pennsylvania, but does that benefit outweigh the cost of the possible competition that mergers eliminate?" said Regina E. Herzlinger, Ph.D., chairwoman of Harvard Business School and author of Who Killed Health Care?. "When there are oligarchies in the insurance market they tacitly collude, because they understand that if they get too aggressive on price competition, they'll have problems," Herzlinger added...

Health care film exposes sore issue, Daniel Lee and John Russell, Indianapolis Star, June 27, 2007

Regina Herzlinger, a professor at the Harvard Business School, said despite its shortcomings, "Sicko" taps into an issue that is ripe for debate. "It's disgusting that a country as rich as ours doesn't have insurance for everybody,' said Herzlinger, also a senior fellow at the Manhattan Institute, a New York think tank. But she has major disagreements with Moore's promotion of a government takeover of health care. "I don't want the government to run it. I want you and me to run it"...

In Massachusetts, test for a pioneering health plan, Mark Trumbull, The Christian Science Monitor, June 27, 2007

"This plan will insure the uninsured. That's very laudable," says Regina Herzlinger of Harvard University in Cambridge, Mass. But she'd like to see consumers empowered with more insurance products in the "supermarket," and more information about their effectiveness. "I now know more about that raisin bran than I do about the guy who's going to do [an operation]," says Ms. Herzlinger, the author of a new book on healthcare...

Retailers Pin Hopes On In-Store Clinics, But Skeptics Remain, Peter Benesh, Investor's Business Daily, June 22, 2007

Given the stampede, you'd think in-store clinics must be a good business. But they have yet to prove profitable, says Regina Herzlinger, a Harvard Business School professor and author of the new book Who Killed Health Care?. "Their business model is questionable," she said. "As stand-alone enterprises, they don't break even". . . It's a turf war, Herzlinger says: "Doctors think convenience clinics will take away business, and they are certainly correct." Doctors don't want to compete by demonstrating they provide better health care at a better price, she says. "Rather than duking it out by proving they're better or cheaper, they run to the legislatures," she said. "I think it's outrageous"...

The Coming Health Care War, Investor's Business Daily, Editorial, June 19, 2007

Michael Moore's new documentary, "Sicko," which opens June 29, has been screened to the press, and it's powerful propaganda. In it, America is a country where health insurers and hospitals kill people... "Federal subsidies enabled managed-care plans to attract customers by offering benefits that other insurers could not," said Regina Herzlinger, a Harvard Business School professor and author of the just-published "Who Killed Health Care?," which makes the case for a new consumer-driven health system... Herzlinger offers as a model for reform Switzerland's long-standing, market-based, consumer-driven health system. "Individuals in the Swiss system can safely and effectively buy insurance from a large number of competent firms," she said. Universal coverage is required and prices for consumers are not risk-adjusted...

Is Health Care Making You Better—or Dead?, Sean Silverthorne, Working Knowledge for Business Leaders, June 4, 2007

Regina Herzlinger is not afraid to call them as she sees them. And what she sees looking at the American health care industry is a bunch of killers. Not only are hospitals, insurers, employers, Congress, and academics killing health care, they are also killing real patients, she asserts in a new book, Who Killed Health Care?. We asked Herzlinger, the Nancy R. McPherson Professor of Business Administration Chair at the Harvard Business School, to discuss her latest work and her more than 30 years of research in the health care industry...

Health-care heretic, The Economist, May 31, 2007

Mrs. Herzlinger is America's leading advocate of market-driven, consumer-orientated health reform... Now comes her latest salvo. "The US health-care system is in the midst of a ferocious war. Four armies are battling to gain control: the health insurers, hospitals, government and doctors," she writes at the start of her new book, Who Killed Health Care?. Then she moves in for the kill: "Yet you and I, the people who use the health system and who pay for all of it, are not even combatants". . .

Health Care Under A Research Microscope Sean Silverthorne, Working Knowledge for Business Leaders, May 30, 2007

The $2 trillion health care system is one of the United States' largest industries—but one of its worst performing by almost any measure other than technological innovation...
Professor Regina Herzlinger, who has studied the health care system for three decades, has an even more damning critique: The current system, she says, "will kill us financially and medically—it will ruin our economy, deny us the health care services we need, and undermine the important genomic research that can fundamentally improve the practice of medicine and control its costs"... Within the last three years Herzlinger authored Consumer-Driven Health Care and the new Who Killed Health Care?...

Health crisis is catching Dallas Morning News, Jim Landers, May 29, 2007

The American health care system is about to get a well-deserved whipping... In June, Harvard Business School professor Regina Herzlinger jumps in with Who Killed Health Care? America's $2 Trillion Medical Problem—and the Consumer-Driven Cure... Switzerland's approach takes health insurance out of the hands of employers and puts it with the consumer. Everyone has to get a policy. Eighty-seven insurance companies sell them, with the government subsidizing the cost for those who can't afford it. If you don't buy a policy and you go to a hospital without one, you'll get care, but you will also get a hefty fine...

Can CDH Resuscitate 'Dead' Health System? Herzlinger Thinks So Inside Consumer-Directed Care, May 25, 2007

Her soon-to-be-released book, Who Killed Health Care?, isn't going to score Regina Herzlinger any points with health insurers, hospitals, employers, lawmakers or academics—who she names as the culprits in the slow (and costly) death of health care. In his review of the book, James Fries, professor of medicine at Stanford University, says the third parties identified by Herzlinger each have "an itchy palm and a commitment to profit or power." What can save this $2-trillion industry, Herzlinger asserts, is a consumer-directed model where consumers and doctors play a much larger role in the delivery of care...

Film Offers New Talking Points in Health Care Debate, Milt Freudenheim and Liza Klaussmann, New York Times, May 22, 2007

Uwe E. Reinhardt, a health economist at Princeton, said that based on reviews, the movie [Sicko by Michael Moore] is "exaggerated, biting, unfair," but he added that a number of recent books and reports by academic experts had been at least as critical. He cited "Redefining Health Care," a book by Michael E. Porter, a Harvard Business School professor, and Elizabeth Teisberg, a Stanford University economist, along with "Who Killed Health Care?" by Regina Herzlinger, also at the Harvard Business School. "My point is we are on the verge of a populist reaction to the health system," Professor Reinhardt said. "The American people are on the point of being fed up". . . .



  • WSAU's "55 Feedback"
  • KBUL's "The Morning Bulletin"
  • St. Louis 97.1 FM's "Vital Signs" with Dr. Randy Tobler and Kelly Webb
  • KSKY-AM's "Insure Your Health with Suzy Black"
  • Sirius Satellite Radio's "As You Think" with Father Paul Keenan
  • Radio America's "Randy Tobler Show"
  • WIBA's "Upfront with Vicki McKenna"
  • WMBI Radio with Steve Hiller
  • WLYU's "What is Going On?"
  • WGTD Radio with Greg Berg
  • WJBC's "The Steve Fast Show"
  • WJR Radio with Warren Pierce
  • "The Small Business Advocate" with Jim Blasingame
  • KCPW's "Midday Utah"
  • WTKF's "Coastal Daybreak"
  • KPOJ's "Thom Hartmann Show"
  • WMOT Radio with Randy O'Brien


Who Killed Health Care? Jamie Glazov,, July 13, 2007

Frontpage Interview's guest today is Regina Herzlinger, a Manhattan Institute Senior Fellow who was the first woman to earn tenure at the Harvard Business School as the Nancy R. McPherson Professor of Business Administration. She has been dubbed "the godmother of consumer-driven health care" by Money and a "health care heretic" by The Economist for her bold consumer-oriented views. She is the author of the new book, Who Killed Health Care? America's $2 Trillion Medical Problem—And the Consumer-Driven Cure...

Point of Contact, Q&A with Regina Herzlinger, Dallas Morning News, July 1, 2007

DMN: You champion consumer-driven care. What is that?
Herzlinger: It's a system in which consumers buy their own health insurance and pay for their health care using tax-protected money. For example, Harvard would give me the money they take out of my salary to buy my health insurance. I could use it to buy health insurance or pay for health care...

Health Care Week in Review, June 16, 2007

Regina Herzlinger, professor of business administration at Harvard University and author of "Who Killed Health Care?: America's $2 Trillion Medical Problem-and the Consumer-Driven Cure," advocates universal, market-based healthcare as the solution to the U.S. healthcare crisis. (Watch video here).