Thursday, February 19, 2015

‘Where Does It Hurt?’ (Book Review)

It’s pretty much common knowledge that America’s health care has needed help for a long time, and that the new “ObamaCare” has serious problems of its own. A lot of opinions have been tossed around, but not too many solutions. That’s where Jonathan Bush comes in. As cofounder and CEO of athenahealth, a medical billing and health care management company, he has a lot of faith in the ability of entrepreneurs to find innovative solutions to our health care problems. With a less regulated, more competitive, and technology-friendly health care “system,” we could be on our way to greater efficiency, lower costs, and more satisfied customers…er, patients. To prove his point, Bush provides a number of recommendations of his own in Where Does It Hurt? An Entrepreneur's Guide to Fixing Health Care (Portfolio/Penguin, 2014) written with Stephen Baker.

There are some “free-market” proposals, which could be expected. There are some personal antidotes, most which I found either boring or irrelevant. And Bush constantly name-drops while simultaneously trying to disassociate himself from the politics of his presidential relations. But what you want to know about is the meat of this book: essentially a brain-storming session, taken down in dictation and published. Not really impressive. Some of Bush’s ideas need to have more details fleshed out before we can reasonably ask if they’re worth implementing. Others strike me as inherently unwise. With all of the relatively-recent scandal and crises associated with Fannie Mae, how anyone can seriously suggest forming the same thing for insurance start-ups without addressing any of the easily foreseeable problems it would face? And the suggestion that quickly-trained Army medics are qualified to take over much of the domain of fully-trained physicians seemed to address health care cost at the expense of health care quality. To be honest, it sounded like veteran Army medic Bush may be a bit sore about having his medical school dreams cut short when he didn’t have what it takes to pass organic chemistry.

While I wasn’t impressed with the authors’ ideas, that’s not to dismiss the entire book. Where Does It Hurt? is a guide for entrepreneurs, not a step-by-step instruction manual. Bush’s enthusiasm is contagious, and the success stories he tells are inspiring. I expect wheels to start turning in the minds of creative young readers, who might come up with some viable solutions. Bush really had any himself, I suppose he would be trying to start those businesses rather than “giving it away” by writing a popular book.

Disclaimer: I received a copy of this book as a First Reads giveaway winner on There was no obligation to write a review.