{"id":257639,"date":"2025-09-12T14:48:00","date_gmt":"2025-09-12T18:48:00","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?post_type=bu-article&#038;p=257639"},"modified":"2025-09-12T15:37:11","modified_gmt":"2025-09-12T19:37:11","slug":"i-hope-this-book-helps-to-inspire-a-new-way-of-thinking-about-healthcare","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2025\/i-hope-this-book-helps-to-inspire-a-new-way-of-thinking-about-healthcare\/","title":{"rendered":"\u2018I Hope This Book Helps to Inspire a New Way of Thinking About Healthcare\u2019"},"content":{"rendered":"\t<div class=\"wp-block-editorial-leadin sphnews-block-editorial-leadin is-style-text-over-image has-media has-media-focus-center-middle has-text-position-x-left\">\n\t\t<div class=\"container-lockup\">\n\n\t\t\t<div class=\"wp-block-leadin-media\">\n\t\t\t\t\n\t\t\t\t<img width=\"2261\" height=\"1325\" src=\"\/sph\/files\/2025\/09\/health-reform.jpg\" class=\"\" alt=\"Accounting doctor, calculator and hands of person calculating bookkeeping finance, hospital budget or medical savings. Mockup space, healthcare and accountant working on taxes, audit or compliance\" loading=\"lazy\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform.jpg 2261w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-636x373.jpg 636w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-1024x600.jpg 1024w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-768x450.jpg 768w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-1536x900.jpg 1536w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-2048x1200.jpg 2048w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-755x442.jpg 755w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-1628x954.jpg 1628w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-900x527.jpg 900w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-1920x1125.jpg 1920w, https:\/\/www.bu.edu\/sph\/files\/2025\/09\/health-reform-1200x703.jpg 1200w\" sizes=\"(max-width: 2261px) 100vw, 2261px\" \/>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t\t\n\n\t\t\t\n\t\t\t\t<div class=\"container-words-outer\">\n\n\t\t\t\t\t\n\t\t\t\t\t<div class=\"container-words-inner\">\n\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"wp-prepress-tag\">hospital care<\/span>\n\t\t\t\t\t\t\t\t<h1 class=\"head\">\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<strong>\u2018I Hope This Book Helps to Inspire a New Way of Thinking About Healthcare\u2019<\/strong>\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/h1>\n\t\t\t\t\t\t\n\t\t\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"deck\">Alan Sager discusses his new book <em>The Easiest<\/em>, which presents a guide to thorough healthcare reform in the US. By strategically redirecting trillions of dollars in wasteful spending, the US can achieve affordable and high-quality care for all.<\/h4>\n\t\t\t\t\t\t\n\t\t\t\t\t<\/div>\n\n\t\t\t\t<\/div>\n\n\t\t\t\n\t\t<\/div>\n\n\t\t\n\t<\/div>\n\n\t\n<div class=\"wp-prepress-component-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">September 12, 2025<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t\t\t\t<ul data-credit-type=\"By\">\n\t\t\t\t\t\t<li><a href=\"https:\/\/www.bu.edu\/sph\/news\/authors\/jillian-mckoy\/\">Jillian McKoy<\/a><\/li>\n\t\t\t\t\t<\/ul>\n\t\t\t\t\t\t\t<\/div>\n\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\t\n\n\n<p>Marred by political constraints, most efforts to win affordable healthcare for all Americans have resulted in a patchwork of costly and often ineffective programs, not real health reform, says <a href=\"https:\/\/www.bu.edu\/sph\/profile\/alan-sager\/\">Alan Sager<\/a>, professor of health law, policy &amp; management at the School of Public Health.<\/p>\n\n\n\n<p>With healthcare spending expected to reach <a rel=\"noreferrer noopener\" href=\"https:\/\/www.healthsystemtracker.org\/chart-collection\/how-much-is-health-spending-expected-to-grow\/#Total%2520health%2520spending,%2520by%2520service%2520type,%25202018-2023;%2520projected%25202024-2033\" target=\"_blank\">$5.6 trillion this year<\/a>, the US pays twice as much per person as other rich democracies. Yet, Americans continue to suffer from inadequate insurance coverage and consistently high rates of preventable deaths and disability, infant and maternal mortality, and noncommunicable diseases.<\/p>\n\n\n\n<p>The good news is that this lack of affordable and equitable healthcare is the \u201ceasiest problem to solve in the United States,\u201d writes Dr. Sager in a new book.&nbsp;<\/p>\n\n\n\n<p>In <a rel=\"noreferrer noopener\" href=\"https:\/\/www.healthreformprogram.info\/the-easiest\" target=\"_blank\"><em>The Easiest<\/em><\/a>, Sager argues that healthcare reform requires the US to contain costs safely, insure all Americans, secure the right doctors and hospitals where they are needed\u2014with adequate pay\u2014and address long-term and mental care, and affordable prescription drugs. &nbsp;<\/p>\n\n\n\n<p>\u201cThe United States already spends enough money to deliver and pay for good healthcare for all 340 million people in this country,\u201d he says. \u201cThe $5.6 trillion we spend on healthcare is six times the nation\u2019s budget for defense. It\u2019s triple education spending. One-half of health dollars goes to clinical and administrative waste, high prices for drugs and other items, and multiple forms of theft. We can win a victory for both competence and compassion with the money we already have.\u201d<\/p>\n\n\n\n<p>Still, political pressure for serious reform is almost invisible today, he argues in his book.&nbsp;<\/p>\n\n\n\n<p>The first six chapters analyze the origins of the economic and healthcare crises and explain why fixing healthcare\u2014not preventing illness or addressing social determinants\u2014is the most effective strategy for reform. They delve into the four types of waste and their causes, and identify reasons for both market failure and government incompetence in healthcare.<\/p>\n\n\n\n<p>Each of the 11 forthcoming chapters describes an important problem, analyzes its causes, and identifies ways to cover all people, contain costs, pay caregivers in trustworthy ways, organize delivery of care, boost the number of primary caregivers, sustain all needed hospitals, and lower drug prices while rewarding those who develop safe and effective new drugs. &nbsp;<\/p>\n\n\n\n<p><em>The Easiest<\/em> is a culmination of three years of work, informed by Dr. Sager\u2019s 50 years of research and scholarship on local, state, and national healthcare problems and remedies.&nbsp;<\/p>\n\n\n\n<p>He has published dozens of reports and studies on Massachusetts and US <a rel=\"noreferrer noopener\" href=\"https:\/\/www.healthreformprogram.info\/u-s-health-reform\" target=\"_blank\">healthcare reform<\/a>,  <a rel=\"noreferrer noopener\" href=\"https:\/\/www.healthreformprogram.info\/about-1\" target=\"_blank\">affordable prescription care<\/a>, and <a rel=\"noreferrer noopener\" href=\"https:\/\/www.healthreformprogram.info\/urban-hospital-closings\" target=\"_blank\">urban hospital closings<\/a>, and has provided steady insight to media covering the <a rel=\"noreferrer noopener\" href=\"https:\/\/www.bostonglobe.com\/2025\/01\/03\/metro\/mass-health-agency-failed-to-monitor-financial-health-of-hospitals\/\" target=\"_blank\">2024 financial collapse<\/a> of the Steward healthcare system, the nation\u2019s largest private for-profit hospital chain. The book is published exclusively online at <a rel=\"noreferrer noopener\" href=\"http:\/\/www.healthreformprogram.info\" target=\"_blank\">www.healthreformprogram.info<\/a> and is available to download for free (marginal cost pricing).\u00a0<\/p>\n\n\n\n<p>In the book, Sager identifies three massive problems that, within just a few years, may create pressure for healthcare reform that will be too intense to be ignored.&nbsp;<\/p>\n\n\n\n<p>The <strong>first<\/strong> problem is a looming federal budget crisis, fueled by international tensions, reckless tax cuts, and the federal government\u2019s yearly $2 trillion deficit. A resulting freeze in federal health spending would trigger a far deeper and broader catastrophe than those expected to arise from the Medicaid funding cuts in the 2025 budget resolution, as well as the pending expiration of enhanced ACA subsidies to buy insurance.<\/p>\n\n\n\n<p>\u201cIf you&#8217;re one of the 10-20 million people who stand to lose Medicaid coverage or subsidized coverage from the ACA\u2014or if you live or work in an area with a hospital closing\u2014the crisis is here and now,\u201d he notes. But far more Americans\u2014almost all\u2014will be affected by the broader budget crisis, he says. \u201cA freeze in federal health spending would bankrupt many hospitals, disrupt doctors\u2019 incomes, and deprive many more patients of financial coverage and actual medical care.\u201d<\/p>\n\n\n\n<p>It\u2019s possible that this crisis will not occur\u2014but it is critical to prepare in advance, he writes. He hopes that policymakers, healthcare and public health professionals, and the general public utilize his book as an \u201cinsurance policy\u201d for this potential crisis.<\/p>\n\n\n\n<p>\u201cBeginning now to plan the responses to a crisis is vital,\u201d says Sager. \u201cIt\u2019s a complicated job that requires considerable time and testing of new methods. Otherwise, panicked responses to a freeze will tear healthcare apart, inflict vast harm on patients, and undermine the public\u2019s confidence. We must be well-prepared to legislate, implement, and deliver the complicated and interwoven changes necessary to capture the trillions of dollars now wasted each year, and recycle them to cover all people, sustain all needed caregivers, and deliver medical security to all Americans. Once the plane\u2019s engine stops, it\u2019s too late to start sewing parachutes.\u201d\u00a0<\/p>\n\n\n\n<p>This catastrophe of the federal financing freeze would be caused partly by healthcare\u2019s own loss of legitimacy\u2014the <strong>second<\/strong> problem\u2014which he attributes to growing awareness of high healthcare costs and vast waste, increasing healthcare revenue year after year to finance business-as-usual, compromised access to care, caregiver shortages, and uneven quality. &nbsp;<\/p>\n\n\n\n<p>The <strong>third<\/strong> looming problem, he writes, is the \u201canarchy\u201d prevailing in U.S. healthcare.&nbsp;<\/p>\n\n\n\n<p>\u201cNo one is accountable for containing cost, protecting access, getting the right caregivers in the right places, or boosting quality,\u201d Sager says. \u201cAnarchy stems partly from the absence of a competitive free market\u2014because not one of its requirements can be satisfied in healthcare\u2014and partly from decades of incompetent public actions. Reform first requires governments to make a few big, strategic decisions to cover everyone, cap spending, and pay needed caregivers well. Second, it requires paying doctors, hospitals, and other caregivers in ways that allow us to trust them\u2014as professionals and fiduciaries and altruists\u2014to take care of all of us well and to weed out waste and low-value care. Liberating doctors to make better decisions about how to diagnose and treat us can ensure good care while capping spending.\u201d<\/p>\n\n\n\n<p>\u201cI hope this book inspires a new way of thinking about healthcare,\u201d Sager says. \u201cReform should win medical security\u2014confidence that, when ill or injured, we get effective, quick, competent, and kind care, without worrying about the bill. It will also contain spending on healthcare\u2014which will liberate money to invest in housing, manufacturing and job training, family and community security, and all the other problems we need to address more vigorously.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Marred by political constraints, most efforts to win affordable healthcare for all Americans have resulted in a patchwork of costly and often ineffective programs, not real health reform, says Alan Sager, professor of health law, policy &amp; management at the School of Public Health. With healthcare spending expected to reach $5.6 trillion this year, the [&hellip;]<\/p>\n","protected":false},"author":15205,"featured_media":257642,"comment_status":"closed","ping_status":"closed","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[2531,2548,2381,2023,2526,2136,2368,2317,2015],"bu-publication":[3516],"sphnews-article-category":[3519,3531,3535,3540],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[481],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/257639"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/15205"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=257639"}],"version-history":[{"count":13,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/257639\/revisions"}],"predecessor-version":[{"id":257687,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/257639\/revisions\/257687"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/257642"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=257639"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=257639"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=257639"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=257639"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=257639"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=257639"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=257639"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=257639"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}