Everyone knows the United States healthcare system is broken
but no one has been able to define a strategy for fixing it.

This is not surprising because we do not have a healthcare system at all. Our non-system is merely a very complicated series of access points that have been created or evolved over many decades in a piecemeal manner without the benefit of an overall design or strategy to guide the process. Because we have a non-system, we have mindboggling complexity, misaligned incentives, unfathomable cross subsidies and the most expensive and least effective healthcare in the developed world. The complexity of our non-system is, in and of itself, a serious obstacle to reform. The proposals floated in the recent Democratic 2020 Presidential Debates have primarily served to highlight the lack of a clear definition of the problem or a clear objective for reform that addresses the underlying cost problems and goes deeper than the slogan level.

Sensible Health Care Reform is a comprehensive multi-dimensional and multi-year program that is based on an evidence-based definition of the problems we face as a nation. The program has as its clear objective “to continually improve the health of all Americans while systematically reducing national health care spending”. This objective cannot be achieved simply by incremental changes to Obamacare or by moving to one of the Medicare for All proposals now being promoted by some 2020 Democratic hopefuls. And while President Trump has already issued two Executive Orders that are positive steps, the Administration has not yet defined a program for comprehensive reform. Moreover, little attention has been paid to how to deal with the nation’s extremely high incidence of chronic disease caused by unhealthy lifestyles and exacerbated by our aging population. These exogenous factors will continue to drive national healthcare spending and call for immediate action.

The OpEd belowA Bipartisan Systematic Approach to Healthcare Reform  - outlines how to organize to get the job done.

The reality is that there is no way to fix our broken healthcare system without first eliminating the unnecessary and counterproductive costs that exceed one-third of our total national spending on healthcare of $3.5 Trillion.

In the short-term most of these cost reductions outlined can be realized by

Requiring all insurance both public and private to be designed around a single identical base policy complemented by choice in supplementary coverage.

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Creating transparency in hospital and physician pricing through mandating the use of prospective pricing based on actual costs.

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Eliminating the tax preference for Employer-Sponsored Health Insurance.

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Transparency in drug prices will drive the elimination of the Pharmacy Benefit Managers.

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… and can be realistically implemented over a few years and will produce a much more efficient system.

Longer-term, continually improving the health of the population and further reducing costs will require much more difficult changes …

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Driving for Healthier Lifestyles (Resource Coming Soon)

... and will take longer to accomplish.

This website has been designed to provide a comprehensive overview of the problems and what it will take to solve them as well as hyperlinks to more complete analyses of the major issues and the data sources used to support the conclusions and recommendations.


The Washington Examiner Magazine article provides a route to guaranteed access without socializing healthcare.

The Letter to the 2020 U.S. Presidential Candidates expands on the Examiner OpEd
and provides additional detail on the definition of the problem and lays out the essential elements of a comprehensive program to achieve a more cohesive
healthcare system.

The Real Clear Politics OpEd, A commonsense workable plan to fix US healthcare, spells out specific steps to realize $1.53 Trillion in cost savings.

A Strategy for Sensible Healthcare Reform summarizes the “integrated set of actions” that will be required “to continually improve the health of all Americans while systematically reducing national health care spending”.

The United States compares very poorly to the rest of the developed world in both efficiency and effectiveness of health care delivery in rankings from the Commonwealth Fund, Bloomberg and the World Health Organization. The 2017 Mirror, Mirror Interactive report can be used to probe the comparisons at a very detailed level.

Implementing a Strategy for Sensible Healthcare Reform lays out a time-phased action program.

About the Author

Fred Gluck joined McKinsey & Co. in 1967 and led the Firm as its elected Managing Partner (Global Senior Partner) from 1988 to 1994. Upon retiring from McKinsey in 1995, he joined Bechtel and served as Vice-Chairman and Director. In 1998 he retired from Bechtel and rejoined McKinsey as a special consultant to the Firm serving in that capacity until 2004.

His extensive background in health care includes serving as the presiding director of HCA as well as on the boards of Amgen, RAND Health Care, and the Cottage Hospital System of Santa Barbara. He also served on the board of the New York-Presbyterian Hospital for over 30 years before achieving emeritus status in 2006. Fred was also the founding Chairman & CEO of CytomX Therapeutics (NASDAQ: CTMX) and LungLife AI, a private company pursuing early detection of lung cancer. He continues to serve on both of these Boards. He also served as Co-Chairman of TrueVision Systems, a world leader in computer guidance for microsurgery, prior to its recent sale to Alcon.

Fred has also written and spoken on health care reform dating back to his service on an Advisory Panel for the Budgeting for National Priorities project at the Brookings Institution in 2005-2006.

Read the Complete Biography

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