Book Club: The Long Fix

I’ve been avoiding reading The Long Fix: Solving America’s Health Crisis with Strategies that Work for Everyone by Vivian Lee. But this semester, one of my students asked if she could read it for her Book Review assignment. I couldn’t really refuse, so I had to read it too.

The author, a physician and healthcare CEO, outlines strategies her team and collaborators have implemented to improve access to care while controlling costs. I expected the usual descriptions of commonsense reforms with great success – and I got that. But I worried that the challenges would be missing. I worried that readers would miss how hard and rare it is to translate successes from exceptional health systems into the real world of dysfunctional healthcare cultures of overworked stakeholders with trust issues. There’s some of that in the book, but it’s still worth reading.

I see why the book inspires health business readers. She outlines the problems we’re all very acquainted with – we pay more for less health, waste, administrative burdens, fragmentation, etc. She outlines her solutions with great explanatory stories – prevention, paying for results, following evidence, improving patient safety, quality improvement, commonsense drug price policies, use data responsibly, engage employers, learn from others, and patient-centered care that includes tools and responsibility to improve health.

It’s a great book to set out a vision – and that’s important. I just want a follow up book to tell us how to get over the challenges, culture conflicts, vested interests, and bias toward the status quo that keep these ideas from happening.