David Gratzer - Independent Practice and The Cure (2006)

Independent Practice and The Cure (2006)

On June 30, 2005, Gratzer completed his University of Toronto psychiatry residency and became registered for independent practice of medicine in Ontario. In April 2006, Gratzer became licensed to practice medicine in Pennsylvania. In May 2006, Gratzer became board-certified in psychiatry.

In October 2006, Encounter Books published Gratzer's book, The Cure: How Capitalism Can Save American Health Care, about problems with the United States health care system.

The problem and the predicament of American health care can be stated in a single, paradoxical sentence: Everyone agrees that it’s the best in the world, but nobody really likes it. On the one hand, we are so blessed with medical breakthroughs that we take them virtually for granted. Cardiac care has been revolutionized in only a few short years; death due to cardiac disease has fallen by nearly two-thirds in the past five decades. Polio is confined to the history books. Childhood leukemia, once a death sentence, is almost always curable… Yet while the quality of American medicine has never been better, angst over American health care has never been greater. The state of Medicare, the cost of prescription drugs, and the numbers of uninsured are all considered crises.

The book advocated moving health-care decisions closer to individuals and their families. Gratzer cited health savings accounts as a success story and bemoaned the state of health care in countries with government-run systems. He advocated various reforms: Gratzer proposed turning over all current federal funding for Medicaid to state governments in the form of block grants to experiment with, using welfare reform as a model; tightening Medicaid eligibility for long-term care; expanding health savings accounts; and encouraging the purchase of private long term care insurance.

In the last chapter, he proposed more far-reaching reforms while acknowledging that neither political party would currently advocate them:

1. "Making Health Insurance Portable": ending the tax exemption of employer-provided health insurance and scrapping government regulations mandating what conditions and whom and at what rates private health insurance companies must provide coverage, thereby making it easier for families to purchase health insurance through their employer, their union, or their church;
2. "Shoring up Medicare": pre-funding the program (either through individual accounts or a trust fund), and raising the Medicare eligibility age to 70;
3. "Creating a Market for Medical Progress": ending the FDA's requirement that drugs demonstrate "efficacy", and return to only requiring pre-marketing demonstration of safety.

The Foreword was written by Nobel Laureate Milton Friedman. He wrote: "David Gratzer is a practicing psychiatrist who combines firsthand knowledge of medical practice in both his native Canada and the U.S. with an independent point of view and a rare capacity for lucid exposition of complex technical material... If you want a well-written, interesting yet authoritative and thorough account of what is wrong with medicine today and how to cure American health care, this is the book for you."

The Cure was named a "Top Ten Reading Selection for 2007" by the National Chamber Foundation.