David B. Nash - How Covid Crashed the System: A Guide to Fixing American Health Care

Praise for How Covid Crashed the System

Global pandemics are always disruptive, but they also represent wonderful opportunities to learn by taking advantage of the crisis invoked. The authors have delivered an excellent analysis on how the current pandemic created several learning opportunities because of the multitude of failures within the US health care system that became widely evident. This analysis of a broken, multi-level system is profoundly insightful and worth the read all by itself. However, the authors take it a step further by also providing a series of superb recommendations on how best to move the current US health care system forward to an improved future state for the betterment of the American population. All who are interested in learning more on how to significantly improve American health care should read this well-crafted and highly articulate treatise.

Peter Angood, MD , president and CEO, American Association for Physician Leadership

This book does an unparalleled job of explaining what went wrong as it relates to Covid and health care delivery. It will take dedication to the principles of responsible innovation to ensure that we do not repeat the same mistakes.

Hemant Taneja , managing partner, General Catalyst

As the authors lay out so well, the pandemic may have uncovered many deficiencies in the American health care system, but through the sharing of their insights, they also reveal the very blueprint for a better system for tomorrow, not just to battle future pandemics but also to improve health overall.

Jaewon Ryu, MD, JD , president and CEO, Geisinger Health

David B. Nash presents an experts view of how a pandemic exposed a systemically fragmented health care system. He reveals how the pandemic further uncovered the counterproductive hierarchical culture within healthcare, the urgency to train professionals across the patient care continuum to function as teams, the undeniable shift toward active patient management of their health and health care, and the crucial need to embrace technological innovations and to make health care accessible to all by fostering equality in public health policies.

H. Richard Haverstick Jr. , interim president, TJU and CEO, Jefferson Health

This is a fascinating, well-researched, and gripping account of one of the most important stories of our time: how the Covid-19 pandemic defeated Americas health defenses and caused so much preventable loss. But while that analysis is crystal clear, the books positive insights may be even more important, because How Covid Crashed the System shows an inspiring path to improve our nations health and make us all safer from the next pandemic.

Leana Wen, MD , research professor of health policy and management, George Washington University Milken Institute School of Public Health

Weaving together compelling real stories with detailed background history, David Nash and Charles Wohlforth have created a wonderful, yet brutal, expos of the deficits in American health care that led to poor performance in the face of the Covid pandemic. They offer powerful insights into the changes we need to make now so we can avoid repeating these mistakes in the future.

Jerry Penso, MD, MBA , president and CEO, American Medical Group Association

A Guide to Fixing American Health Care

David B. Nash, MD, and Charles Wohlforth

ROWMAN & LITTLEFIELD

Lanham Boulder New York London

Published by Rowman & Littlefield

An imprint of The Rowman & Littlefield Publishing Group, Inc.

4501 Forbes Boulevard, Suite 200, Lanham, Maryland 20706

www.rowman.com

86-90 Paul Street, London EC2A 4NE

Copyright 2022 by David B. Nash

All rights reserved . No part of this book may be reproduced in any form or by any electronic or mechanical means, including information storage and retrieval systems, without written permission from the publisher, except by a reviewer who may quote passages in a review.

British Library Cataloguing in Publication Information Available

Library of Congress Cataloging-in-Publication Data

Names: Nash, David B., author. | Wohlforth, Charles P., author.

Title: How Covid crashed the system : a guide to fixing American health care / David B. Nash and Charles Wohlforth.

Description: Lanham : Rowman & Littlefield, [2022] | Includes bibliographical references and index. | Summary: An influential, big-picture thinker and a science writer investigate why Americas health care system failed so tragically during the Covid pandemic and how the forces unleashed by the crisis could be just the medicine for its long-term cure Provided by publisher.

Identifiers: LCCN 2022004606 (print) | LCCN 2022004607 (ebook) | ISBN 9781538164259 (cloth : alk. paper) | ISBN 9781538164266 (epub)

Subjects: MESH: COVID-19economics | Delivery of Health Careorganization & administration | United States

Classification: LCC RA644.C67 (print) | LCC RA644.C67 (ebook) | NLM WC 506.7 | DDC 362.1962/414dc23/eng/20220525

LC record available at https://lccn.loc.gov/2022004606

LC ebook record available at https://lccn.loc.gov/2022004607

The paper used in this publication meets the minimum requirements of American National Standard for Information SciencesPermanence of Paper for Printed Library Materials, ANSI/NISO Z39.48-1992.

To the thousands of health care workers who gave their lives caring for patients and the hope we can build a system that makes such sacrifices unnecessary ever again

As coauthors, we decided to investigate the root causes of Americas Covid crash before the pandemic was half over, and our research and writing continued amid the events the book describes, ending in December 2021. We could not have attempted this audacious mission without the help of many people who helped with day-to-day tasks, provided critical insights and descriptions, and reviewed pages for errors. We thank all of those who made our work possible, especially Davids remarkable wife and daughter, Drs. Esther and Rachel Nash, who also appear in the book. Charles also especially thanks his wife, Sarah Rowland, for her patience and loving support.

Dr. Sandro Galea was extraordinarily gracious and responsive in providing his introduction to the book, which perfectly frames and highlights our subject. Dr. Stephen Klasko was Davids colleague and mentor through an extraordinary period of growth and innovation at Thomas Jefferson University and its health system. We are deeply grateful for his insightful foreword. David is also thankful for decades of support from Dr Mark Tykocinski, the provost of Thomas Jefferson University.

Davids brilliant student, Zach Goldberg, performed essential research and provided editorial comments. Davids assistants, Victoria McMonagle and Elizabeth DeBonis, were critical parts of the team from beginning to end. Literary agent Sara Camilli and Rowman & Littlefield editor Suzanne Straszak-Silva guided the work from concept to print.

An extraordinary list of doctors and other experts on the health system helped develop our thinking and bring the book to life, including Dr. Theresa Andrasfay, Dr. David Ansell, Dr. Nick Bloom, Dr. Sandra Brooks, Dr. Christopher Cannavino, Dr. Marty Cetron, Dr. Mary Cooper, Timmy Del Vecchio, Dr. Karen DeSalvo, Michael Dowling, Dr. Lisa Eyler, Julie Freeman, Michael Fronstin, Dr. Jonathan Gleason, Dr. Oren Guttman, Dr. Judd Hollander, Marty Lupinetti, Dr. Bruce Meyer, Dr. William Mobley, John Nance, Dr. Alex Navarro, Dr. Lawrence Prybil, Dr. Jaewon Ryu, Dr. Byron Scott, Dr. Steven Scheinman, Dr. Mark Schuster, Dr. Olga Shvetsova, Dr. Leana Wen, Dr. Leah Windsor, and Jeff Zucker. We are also grateful for the corrections many of them provided, although we are responsible for any remaining errors.