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Oxymorons: The Myth of a U.S. Health Care System

ISBN: 978-0-7879-5970-8
256 pages
October 2001, Jossey-Bass
Oxymorons: The Myth of a U.S. Health Care System (0787959707) cover image


In this impassioned and often vitriolic book - a follow-up to the author's bestselling Bleeding Edge: The Business of Health Care in the New Century - U.S. health care industry expert J.D. Kleinke offers an unflinching look at our broken health care system. Throughout the book, Kleinke - who was once a vocal advocate of the managed health care system - explains what went wrong and attempts to answer such perplexing questions as:

Who's in charge of the American health care system?
How does managed care work . . . or not work?
Why have hospitals become so complex?
What are the prospects for reform?
Does the Internet change anything?
Can we solve the growing problem of the uninsured?
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Table of Contents



About the Author.

1. Wars, Strikes, Riots, and Acts of Congress.

The Accidental Patient.

The Accidental Provider.

Is There a Doctor in the Corporation?

A MedicalChicken in Every Pot?

I m from the Government, andI m Here to Audit You.

Back Alleys and IntegratedCare Systems.

Chocolate and Vanilla Politics.

2. Playing with the Boss s Money.

Ten Thousand Little Health Care Systems.

Life in theData Mines.

Continuity Conundrum.

Stuck inFifty Catatonic States.

Toward a New Federalism?

Who Benefits from the Proliferation of Benefit Plans?

3. The HMO Will See You Now.

Diagnosis: Organizational Multiple Personality Disorder.

Data Speak Louder Than TV Ads.

MCO MultiplePersonality Disorder, Deconstructed.

Who Buys anOunce of Prevention?

You Get What You Pay For.

4. The Health Care Jobs Program.

The Managed Care Jobs Program.

Life on the HospitalChain Gang.

Old South, New South.

Spoonfulsof Sugar.

5. Chaos in the Clinic.

Having a Bad O Hare Day.

From Here to Infinity.

Why It Is Called Medical Practice .



My Data Can BeatUp Your Data.

From Infinity Back to Here.

6. Vaporware.com.

Nightmare on Wall Street.

A Fix for Health Care sPermanent Love Triangle?

Is There a Doctor in theCorporation.com?

Whose Preferred Provider?

Open Your E-mail and Say Ah .

Nightmare on WallStreet: The Remake.

7. A System for the Uninsured.

A Not-for-Profit Hospital by Any Other Name.

Waitingfor Godot s Reform Plan.

8. A Simple Plan.

My Tax Break Is Your Tax Break.

ERISA (or SomethingLike It) for All.

The Benefits of Standard Benefits.

9. Personal Effects.


Index.Contents viii
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Author Information

J.D. Kleinke is a medical economist, health information technology executive, and the founder and President of HSN, a medical software development company headquartered in Colorado. During the 1990s, he served as Vice President of Corporate Development for HCIA Inc., helping grow the company from a start-up hospital data analysis firm into a pioneering, publicly-traded provider of health care information systems and products. Before joining HCIA, Kleinke was Director of Corporate Programs at Sheppard Pratt Health System, where he developed and managed the nation's first provider-based managed mental health care system. Kleinke's work has appeared in The Wall Street Journal, JAMA, Barron's, Health Affairs, the British Medical Journal, Modern Healthcare and numerous other publications.
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"In his first book "Bleeding Edge," and his editorials in The Wall Street Journal and elsewhere were his argument on behalf of managed care, then "Oxymorons" is his mea culpa." (The Wall Street Journal, 12/11/01)

"The book is interesting, easy to read, and flows smoothly." (Journal for Healthcare Quality, October 2002)

"J.D. Kleinke takes us on a fearless, often harrowing journey to the beating heart of the U.S. health care system, dispelling much of the conventional wisdom about what is wrong with that system, and focusing our attention on what will and will not work to fix it. Oxymorons is a comprehensive, uncompromising, and durable milestone in the annals of health policy, medical, and business literature." — John Iglehart, national correspondent, New England Journal of Medicine and founding editor, Health Affairs

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