Roberts Books

This book sat on a shelf at my parent house for years before I finally picked it up and read it. What a wonderful treasure to find! The story is set in a small, isolated, Italian village during the second world war. The townsfolk manage to live quietly undisturbed by the war - that is, until it is reported that a German regiment has been installed in a nearby town and is planning to visit the tiny mountain oasis. What ensues is a mad race by the townsflok to hide a precious secret from the German invaders while appearing to be hospitable and cooperative. To some degree everyone in the town is enlisted to participate in the massive con job (to varying degrees of sucess). You won't be able to put it down. It's a great, fast paced read with an excellent plot and character development.

Deep within the Roman Cave there is the wall. It is all that separates the Germans from the wine that they covet. Yet they cannot see it, because the wall is an illusion, an illusion that protects the wine. The wall, as an illusion, is symbolic
of the real secret of Santa Vittoria. Nothing and no one are what they seem to be. There is Bombolini, the clown, who is a student of Machiavelli and the only one capable of leading his people in this time of crisis. There is Babbaluche, the cynic, who is willing to give his life for his village, because his death will be the greatest joke that he can perpetrate upon the German invaders. And then there is the Malatesta. She, who is the aristocrat amongst the peasants, will give herself to Captain Von Prum to save the life of Tufa. Who better expresses the value and significance of one life? The great irony of the novel is of course that she must pay the price for her act, because she is a woman. Yet she and Babbaluche are the real heroes of the novel. They see the reality of the situation and they have the courage to act on their convictions despite the consequences. And then there is Bombolini, the clown, who will manipulate the illusion to save both his people and the wine.

There's a beat up paperback copy of this book in the laundry room of my apartment building. I picked it up during a spin cycle and have been working through it one chapter at a time.

The characters are fantastic, and I hate to put it down each week. Truly hope no one cleans the back shelf before I get to the end.

Save yourself the trouble, and buy your own copy.

Beautifully written characters populate this wonderfully crafted story of a tiny Italian town's struggle to protect its lifeblood (both spiritually and financially) from an occupying German force during WWII. The crux of the plot is an amusing battle of wits, philosophies and endurance between the town's bumbling mayor, Bombolini, and the staid German Captain, Von Prum. Guiding each man's actions and outlook are the teachings of Machiavelli and Nietzsche, which makes for an "interesting" coupling. The story showcases the heart and humor of the Santa Vittorians, who are much more than what they seem. Eight years after first reading it on the recommendation of my 12th grade Philosophy teacher, I picked it up to enjoy the story all over again.

I simply echo the others - read this book - it is wonderful.
It's full of the drama and comedy of life, like a fine play. Yes - the characters can be seen as stereotypes, but more often they evolve into a rich complexity, as their lives and ideals clash. Their close comunity and common dangers propel them through a suspensefull and wryly narrated struggle. Like Steinbeck, Crichton crafts the events of a time to work changes on people and force out their best, and so the tale inspires. I read it years ago, and reread it, and then gave it away. Now I have regained it (used), and find myself again rereading it. Why in heaven's name is this book out of print?

I would have given a much lower score based on an HPL feel scale; but I must admit the product is solid even if it has nothing to do with classic CoC; its a totally different game.
That other type of flavor game was mainly to appeal to people that:
1) Felt uneasy to play in the 20s
2) Wanted more fire power or modern organized resources
3) Were fan of X-Files even if DG came a bit before the TV series, the popularity grew much after that

So its a good game to play Mulder and Scully or even men in black kinda investigators with those sunglasses and Steyr rifles
Its definitally Modern horror type and not for the classic HPL type of game fans

This amazing game (and just plain interesting read!) is currently back in print. You can pick up the new edition, converted to D20, by heading to the publisher's web site. Pagan Publishing and TC Corp have done a great service to its fans by releasing this reprint!

I don't have a long, thoughtful review to write. Just wanted to say this is the BEST RPG idea/supplement I've ever seen. Intelligent, thoughtful, scary, fun...get it get it get it!

This is the best RPG suppliment I have ever read, bar none. It's a great READ, even if you are not a gamer. Interesting background, lots of plot hooks as well. The group that did this book are great writers and are loving what they do and it shows. If you are into Horror, X-Files, Call of Cthulhu, ect...buy it to read, if not play.
The book is curently out of print, but I understand that it will be reprinted in 2006 as a hardcover with d20 rules. Anyone wanting to write or publish an RPG should read this book and use it as an example. A MUST.

DELTA GREEN is the modern adaptation of Call of Cthulhu. Drawing on the same body of UFO lore and paranormal activity as the X-Files, DELTA GREEN has tapped into something very deep. And of course, once you have a successful RPG, you might as well start the fiction flowing, right?

Dark Theaters has some fairly lenghty short stories, designed to flesh out the world of DELTA GREEN. Some clues and hints are elaborated on; what exactly happened during the fabled raid on Innsmouth in 1928? What was the final mission of Gen. Fairfield? We find out more about the summoning by the Karotechia that was a dress rehearsal for the end of the world, but the entirety of the episode remains tantalizingly removed.

Dark Theaters, like the rest of DELTA GREEN fiction, is about what it means to be human. Or not human. The monstrosities which are called up and cannot easily be put away serve to highlight our humanity. But in the end, humanity is just short-hand for a fundamental incomprehension of the universe. We are carrying on a rear-guard action against reality, buying our fellow-man time for ... what? To say that humanity loses in the end is to pretend that there are other players, rules agreed upon, some validity to having tried and lost. Life is a game of solitaire, and we're not playing with a full deck. All is meaninglessness, a blowing of the wind.

And yet humanity means staying in the game. Like Lucifer, the real patron saint of lost causes, we know that we will lose and darnit, we are going to keep playing the hand we were dealt. It gives meaning to life, death, and the passing of the seasons, the sacrifices we have made and those we have sacrificed, to play by the rules, even if there aren't any. So let us cheer for the hero and jeer for the villain, and not go gently into that dark night.

I thought this was a well written book on the fundamentals of demonstrating and or presenting software. I am a big believer in "Discovery" it makes for a much better and targeted demo. I also particularly like the metaphor he uses of "crossing the bridge" and how applying the principles in this book can help our prospects bridge the gap. He has some great nuggets for sales people who are involved in enterprise or consultative sales. Don't let the title fool you,(not just for SE's) I would recommend this book for all sales people who are interested in mastering their craft!

Excellent Book!!!



Since 1988, I have conducted many system software demonstrations!!

Demonstrating to Win touches all of my experiences from small client engagements to some one pulling out the plug of a mini AS/400!

By reading this book, I felt like you were a spider on the wall recording my many demo successes and failures.

Good Job.





Kevin M. Lee

Industry Director:

High Tech & Electronics

SSA Global

8913 Metheny Circle

Tampa Florida 33615



C 813-495-0332

O 813-249-0961


Kevin.Lee@ssaglobal.com

This is an excellent how-to book for improving your discovery and demo skills for enterprise software sales.

Chapter 4 (Demo Crime Files) and Chapter 5 (Discovery Process) more that justify the price of the book.

I sincerely wish that all presales engineers would read this book before presenting to customers.

I read Demo2Win and fell in love with the concept. After years of demonstrating software, I always felt like I could have done better if I had more tools. Robert's book gave me those tools. The tools I remember from the book were simple. Just be a little different than the other person or company. The Discovery Phase in the long run will save you and your customer time. You will find out if you can supply what the customer needs or leave it to someone else to fulfill their needs. Why waste time. The Demo Crimes made me cringe because I know I've committed a few of them over and over. Now I won't commit those crimes because it's been brought to my attention by Robert.
After I read the book I asked my boss to read it. He read it and ordered about 30 copies for all of our salesforce to read. Each and every person that read it then praised it. It was kind of like the lights went on in everybody's head.
I'd recommend this book to any salesperson. I've already read it more than three times. I take it on each flight I make and read at least a few pages each time.
Thanks, Robert.

Demonstrating To Win is an exhaustive book on the topic of demonstrating software by experienced hand Robert Riefstahl. The author delves into the subject at hand with precision and detail through chapters like Demonstrating Is Not An Art!, Important Demonstration Concepts, The Demo Crime Files! and Your Demonstration Setting. There can hardly be a better resource than Demonstrating To Win for professionals in the industry. The book covers the obvious, mundane and elementary to the detailed nuances and tricks of the trade and aims to articulate the author's main thrust that in order to win the day the presenter has to build a bridge that the prospect wants to cross in order to reach you (and your software product).
Each chapter is augmented by a brief summary which offers a synopsis of the topic covered and the author practices what he preaches by offering his experience in plain language. There certainly are a couple of instances where the reader will notice the book's age and its year 2000 publication date, most notably during the technical discussions, but Riefstahl's guide is comprehensive and advantageous all the way through and still relevant to those demonstrating software to potential customers.

As an already-successful author (Rewired, Rehired, or Retired? Jossey-Bass/Pfeiffer 2002) and sought-after international speaker, Bob Critchley is eminently qualified to speak with authority on the labour market of the future.

Whilst not alone in ringing the warning bells, Critchley has much more to offer than an alarmist message ... and he couldn't make it easier for us. He goes beyond illuminating the impending labour crisis, he has the strategies and solutions too.

Company Directors, CEO's, Management and especially HR advisers need to have this book on the top of their "must read" list!

So how does an organization maintain and maximise a multi-generational workforce, remain flexible yet successful and also be seen as an employer of choice? Critchley's answer is clear ... "Doing nothing is Not an option!".

Exactly what to do is made abundantly clear in this eminently sensible and readable book from someone who has impeccable credentials and vast experience. Carolyne Burns, MD, Influence InterPersonal Profiling, Sydney Australia

We all know the importance of trusted and experienced people in successful businesses......why then are they often overlooked in favour of the "new model" or the "grass is greener" scenario? Critchley really brings home the message that these people are key and will be absolutely key for organisations to main tain their position and advantage.The book is a must not only for HR professionals but also for all managers and company directors....from an author with extensive practiocal knowledge and successful experience of practising what he preaches.

Bob Critchley has produced an outstanding people management guide. The author's deep practical experience is evident as he shares his insights into effective management of people in all age groups. At a time when there is a growing shortage of talent in most developed economies, knowledge from this book can help put results on the bottom line in most business organisations. This book is easy to read and hard to put down! Colin Durand, The Insight Executive Search Group, Sydney Australia.

Bob Critchley's book provides a powerful and compelling argument for "thinking outside the box".

The population demographics are inevitable and organisations ignore them at their own peril.

Unless organisations adopt flexible ways of engaging employees and think laterally about how to maximise the contribution of every single employee, they are doomed to become victims of the demographic reality.

Critchley's book not only provides the evidence and demonstrates the inevitibility - but he also provides a compendium of ideas about how to respond.

An invaluable guide to any forward thinking HR professional.

Time marches slowly on and we all tend get caught up in our day to day and short term activities. Just like when global warming incidents started to occur. In isolation they meant little and then a pattern and explanation emerged. Critchley pulls together the signs in our demographic and employment changes. Dramatic shortages in skilled labour arise; a lack of investment in infrastructure becomes apparent; retirement and aged care issues start to be reported in the media; the funding of retirees becomes a federal budget issue; government start to create incentives to get people back to work. For those who run businesses other symptoms become apparent. So often the employer has to convince the prospective employee why to join them; the employer becomes aware of impending skill losses as older employees approach retirement age; people talk about not wanting to fully retire and having flexible arrangements; the employer can't find the right people.
Critchley's book suddenly pulls all these incidents and changes in attitude together into one easy flowing cohesive read. He paints a picture of why things are happening and what is likely to continue to happen. More importantly he canvasses what needs to be done for organisations to be successful in this environment. Many organisations pay lip service to people being their most important asset and often they have a short term focus. Critchley really sets down some ideas and a framework that organisations, who really do value people, will need to adopt to be successful in the long term. A must read.

I give this beautiful book all the time as gifts for grads of all ages, including high school and university. It's a multilayered book, and a thoughtful reader will discover more each time they open its pages. The illustrations and text in "Dream" have a simple level for younger readers, but teens and adults will see other layers through the symbolism and metaphor that speak to the heart and spirit. Two pages at the rear of the book discuss many of the layers of meaning. This is an amazing book and I highly recommend it as a gift for occasions like a birth, birthday, or grad.

I purchased several of these books as high school graduation gifts based on recommendations. I felt the illustrations and text was far too childlike to give to a high school graduate and therefore ending up returning them all.

This book made excellent graduation gifts for several high school graduates this year. It helped me convey my greatest wish for each of the recipients--to keep dreaming. I also use the book in my classroom and use many of the activities at the related website to help my students learn more about dreaming and then taking the steps to make those dreams come true. http://www.legacyproject.org/

The book contains one of my favorite poems-Dreams by Langston Hughes. The whimsical illustrations highlight the wonderful message this book conveys. I would highly recommend this book.

Being a fan of Kittie Nesius Beletic's "What Color Is You Dream?" published by Brown Books Publishing Group, I thought I might enjoy this book, "Dream: A Tale of Wonder, Wisdom, & Wishes" by Susan V. Bosak, so I ordered it. I am glad that I did! :)

Dream really does capture your heart, mind, and soul with its guiding text, kaleidoscope-like personalities, human diversity, and vibrant art, which was rendered by 15 top illustrators. The beautifully detailed book cover entices readers to open the book quickly and explore at leisure. The silver, star-filled end sheets really do make one believe that he / she has a special product in hand, and they too are useful for contemplation. The book's fonts are friendly, large, and easy to read--especially for eyeglass wearers. Colors in this book are used to convey moods and shade meaning.

I like how the book opens with the definitions of dream and the illustration of a person opening a huge chest at the end of a glorious rainbow. The in-text prompts to "Dream a Dream With Me" are clever devices to tie the ideas together into a unified whole. Quotes from key figures add much to the pages, given them depth and reach. Most helpful is the book's "Explore the Illustrations" notes, which comment on the artists as well as their work.

Educationally, this book promotes keen observation, critical thinking and response, personal expression, historical-mindedness, humanity's strengths / successes, awareness, courage, gratitude, and the ages and stages of human life. Potentially, it encourages reading and research beyond its own pages. It is appropriate for a variety of audiences, teens to adults. Book messages are especially appropriate for folks who are taking new road's in life's journey: graduates, folks recovering from illness or injury, people who are moving to new places, people who are retiring or rethinking their lives, etc.

To make the most of the book, avid readers can visit the official Legacy Project website and find more materials to explore. Educators will enjoy the guides, suggestions, and activities in the "Begin and End With a Dream" section of the webpage. Contests and workshops are also available on the site.

Perhaps my favorite portion of the book is the "Great ideas--the impossible made possible" pages (16-17). From medieval to modern, the rich image illustrates humanity's collective "learning lab," where the world's most influential discoveries and inventions can be found. The more you look into the image, the more you see, the more you feel connected to something larger than yourself! You begin to realize how much your life has been influenced, affected, and improved by other people's dreams, their contributions to humanity. Some of the highlights of this image are the following:

1) the medieval window that opens to a refreshing view of sea, land, and sky

2) the sconces

3) a retro-modern looking TV that is broadcasting the moon landing

4) Computer, book, papers, and pens

5) Rocket models, engines, and pictures of various flying machines

6) Basic tools, gears, printing press, hour glass

7) Telescope, telephone, microscope, electricity devices,

This book would make a great gift or achievement / award book. It is a worthy product for personal study and group discussion. Humanities instructors could glean much mileage from this source, a great supplement to lesson plans, special projects, multiculturalism, diversity, art appreciation, history appreciation, philosophy, literature, etc. Home schooling families might find the book useful in bring some interdisciplinary flavor to their curriculums.

Truly, no one dreams alone...because when dreams come true, many people, many lives are forever touched.

This is a beautiful, well written book and a great gift for anyone working toward a goal.
Each page takes you through a color of the rainbow, and through a stage of life. It offers hope for those who may have hit a rough spot in attaining their "dream". I received it as a gift and bought 6 copies to give away. It's a book I will read again and again!

This is a great author and great book. I experienced many personal connections regarding my Native American ancestors and healing practices within the pages of this book. Very easy read. This book lead me to many other books written by the same author.

Robert Moss's deep experience in the dreamscape is unlike any other shaman-writer in the West. As in all his books, this one shows the mark of a real shaman. In Dreamways of the Iroquois, Moss is more revealing about himself even than in his previous books. In spite of this personal tone, the book is scholarly at times. Interspersed with a retelling of the ancient myths of the Iroquois and Huron people, the children of Aataensic, is Moss'initiation by Island Woman, an Iroquois guide who leads him into the wisdom of her ancient people. One of the book's most potent message is that dreams reveal the real desires of the soul and should be honoured. There's little instruction here on how to work with dreams (one chapter does it) as the book is more of an exposé and a manifesto for the rebuilding of a dreaming society. I recommend all Moss's books to people interested in dreamwork as they are all very deep and rewarding.

A great book that explains the doorway to our dreams and how our dreams may help us face up to lifes challanges. A wonderful read and the author has clearly spent time in other realitys that are just as real as our own. There are many guides and messengers that can help us through our dreams if we are open to them and can remember how to communicate in this fascinating world.

As life if filled with messages, both in dreamtime, and time awake Moss guides us to listen to the spirit of your destiny. Moss was called to his dream writing and workshops and this book continues his teachings in understanding your dreams and and nurturing your intuition. Recently picked up a book by Wanda Easter Burch called She Who Dreams. Come to learn Burch and Moss met in New York many years after Burch dreamt of a young boy drowning, which happened to be Moss. Do not believe in coincidence and if you are looking for a path to understand your truths in life, this book will help your realization.

Dreaming is good for writing the next day. Dreams know a lot; what is dreamed must come to pass. If not, one's nature is not followed which, is the way of sickness instead of joy and good luck. I hope this book will help me along in this writing about the ancient goings-on. If you study Iroquois, you will dream vividly and feel special when looking at stars.

Wonderful is too weak a superlative to describe this book. Written in a factual style and incorporating historical events such as Peary's trek to the North Pole, it is one of the most delightful stories about Christmas ever written. There is also a detailed account of the land expedition by Will Steger, the only man to actually see Santa's village at the North Pole.
The chapters are:

*) The reindeer by the river: It was a wondrous thing. In which the author tells of his search for the true Santa Claus.
*) The echo of hooves: Searching for yesteryear's reindeer. In which Santa's history is detailed, past adventures are recounted.
*) The North Pole today: On the roof of the world. In which the kingdom is visited, the elfin life is described.
*) The miracle of reindeer flight: Mysteries explained, science revealed. In which the way he does things he does is discussed.
*) Eight tiny reindeer (Plus one): Santa's starting team and his helpers. In which a host of heroic animals and people are met.
*) Like down on a thistle, evermore: Work that never ends. In which the future of Santa Claus and his mission is pondered.

The spirit of Santa Claus within the concept of Christmas is a powerful one, in this book you can capture some of that spirit and appreciate the strength of the man and his mission.

I have this book, with some handwritten annotations. The author got a couple facts wrong, but then I used to be in the Air Force, worked in many. many different command posts and operational centers, and well somethings are still classified. Some good guessing and all!

Cute book, I love it, my husband, a "Santa Helper" loves it, our teens liked it (really!) and the few copies I have given as gifts were very well received.

If you have older kids this is a great book.

I have the movie with Bridges and Thomas and I love it. It is called "The Christmas Secret" it is suppose to be taken from part of the book "Flight of the Reindeer" I don't know if that is true or not. Because I did not buy the book yet.

There is a Santa Claus! This is an amazing book, written in documentary style about the existence of Santa and his reindeer. It is a delightful addition to anybody's coffee table at Christmas time or any time. I really love his description of how he found Rudolph, and how he guided the team that one year, a small reindeer with a big heart. The description of the reindeer's year is fascinating!

This book will warm the hearts of Virginias everywhere. Yes, there is a Santa Claus!

I found this a long time ago in a bargain bin for $2. I *love* this book--it's one of my all-time favorite books. Although I haven't put up a tree in years, it's now a tradition to read this book every year. It puts me in the Christmas spirit--and adds realism, proof and perspective to the Christmas mission.

Buy it and make your own family tradition.

Spectacular Photos and what an athlete. His death was a loss, but he lives on in these images

this book was amazing, the pictures are stunning, and the stories about him are almost unbelievable. I highly recommend this book for fans of photography or anyone who loves the outdoors.

If you are familiar with with the work of Galen Rowell I don't need to elaborate on the beauty and quality of his work, if you aren't familiar with this man and his work it will be a valuable addition to your knowledge and enjoyment of photography. Galen Rowell had an unfortunate and untimely death
after a very active life of globe trotting for photography that transcends
the material plane. The book presents many of his best works in a lovely format. A coffee table book that will get noticed.

This is more a short biography with too few of the beautuful photos this talented outdoor photographer made. I would have like to have seen more full page photos and more of them.

If you have every looked at Galen's photos and wanted to see more, this is it. With his life cut short, at least we still have archived material that can be released in a book this nice to bring us more glimpses of his world. The color is amazing, the subjects grand, and Galens storys bring it all alive in my livingroom.

I live 2 miles away from West Pittston and know people who either knew the Smurls or who are related to them. I actually attended their national press conference when all of these events occurred. I will *never* forget the feeling that I had when I first heard the story as a teen.
I used to be really well read with this topic but once the 'drama' of it all died down I didn't think much of it.
I became interested once again because last week at a party I spoke with someone who is the nephew of the Smurls. He claims that the events were true and even said that something happened one day while his dad was visiting them. Another girl that I know was a next door neighbor to them and swears of its truth because she, herself heard things. These are seemingly 'normal' people who I have known a while.
...It is a very intriguing story that was, in my opinion, ruined by the 'Hollywood' interpretation via the made-for-TV movie.
Currently the family lives about 8 miles from their former Chase Street home in West Pittston. The people who live there now, as far as I know, have had no disturbances.
This book is a great summary of events and gives me even more chills because I am so close to the source.

For those that know anything about Ed and Lorraine Warren, you know that they are the real deal. This book, which was made into a horrible, less than thrilling TV-Movie, is truly amazing, fearful, terrorizing, scary, intriguing.... and more. I first read this book when I was in high school and I had nightmares for weeks. Since then, I've enjoyed all the account the Warrens have provided on their website, and hope to still enjoy more information Lorraine may provide (Ed passed this past year).

If you are interested in the paranormal, hauntings or the supernatural, this book is an incredible read! Be warned, it will give you goosebumps and you will be scared! At least, any normal person would be! If you are interested in learning as much as you can about these topics, you really SHOULD read the book!

I read "The Haunted" many years ago as a teenager and was totally moved and even scared to read about the Smurl's horrible event that plagued their lives and home.

This book is an in-depth read, and puts the reader inside the lives of the Smurl family. I felt like I was part of the family with everything going on. It's certainly a page-turner. The pictures also make the text come to life.

Given all the bad things that happened, their faith and strong family ties and values made them overcome the paranormal activity. The activity stopped around in 1986 or so. It's 20 years later. I wonder how the Smurl family is doing?

I read the book, and can relate to the truth because of my own experiences with the paranormal.
This is by far the scariest demonic case I've ever read about...
This world does contain mystery.

I rarely read books, but this one caught my attention (possibly because of the fact that it is a true story). I just could not put this book down. I had read for several hours the first night. I did, however, have to turn on several lights because I kept hearing strange noises in the dark! (And the slightest creaks had really startled me!) After I could no longer keep my eyes open (after three in the morning), I did have to try to get to sleep (not completely in the dark, though). As soon as I got up less than six hours later, I picked up the book and I didn't put it down until I was finished. I was so hoping for a happy ending after all of the torment the family had endured for so long. Their story is completely believable and extraordinarily written!
I would give this book a lot more than just five stars. Superb!

The work points to many of the negations in the current health
care delivery systems in the USA. It spends too much money and
the paperwork is burdensome, generally uninformative and
inefficient. The system needs a separation between the doctor
and the pharmaceutical industry because the needs of the general
public demand an independent attitude on the part of physicians.
Emergency rooms are utilized instead of patient clinics.
This contributes to bloated costs. The HMO co-pay can be burdensome for patients. In addition, there is a slow migration
toward the universal health care coverage in order to correct
some of these inefficiencies and distribute the resource to
persons uncovered or undercovered by the present protocols
and medical delivery systems.

In more than 20 years teaching a course focusing on analysis of American health care history and policy, I have yet to discover a more persuasive diagnosis of our health care delivery system's ills or a more convincing case for how to cure them. Dr. Lebow brings to this examination direct experience as a practicing physician from which he draws numerous stirring personal accounts. To his clinical perspective, he adds an extraordinary command of the broader economic and political issues essential for understanding the context and causes of America's current health care crisis epitomized by the alarming number of our country's uninsured--now about 44 million and growing. The book is honest, engaging, and sure to stimulate discussion with its clear prescription for change. With lively prose and strategically placed humor, he makes complex matters understandable. His humanity and passion are the earmarks of a brilliant teacher. Regardless of how deeply you presently understand America's health care system, you can learn from this book. And regardless of your political inclinations in respect to his advocacy of a single-payer solution, you can't ignore his meticulous presentation of the facts or the relentless logic of his conclusions from them.

Health Care Meltdown: Confronting The Myths And Fixing Our Failing System by Robert H. LeBow (former Medical Director of an Idaho community health center for more than 25 years and who was paralyzed in a cycling accident shortly after completing this book) is a clarion wake up call focused upon the medical care system's rampant excesses, over billings, neglects, and quagmires that floods the American health care system to near incapacitation. Over 40,000,000 Americans have no health insurance. This places an unsupportable burden on Emergency Room Care (one the most expensive health care provider resources), and while money is in unnecessary and wasteful bureaucratic and law-suit avoidance oriented testing, far to many people simply go without the medical service they desperately need. A sharply worded criticism that also offers models for reform and improvement, Health Care Meltdown should be mandatory reading for health care providers, citizen health care activists, anyone charged with the responsibility of developing policies and guidelines for managing health care services.

I'd like to give this book 4 stars, but there are just too many holes for me to do so. Dr. Lebow presents many important points, but the book simply is not the answer to our prayers regarding the current healthcare mess.

As Dr. Lebow points out, in the health insurance industry, competition among health insurers has led to less efficiency rather than more efficiency. 10 different credentialing applications, 12 different contract types, no standardization whatsoever and an administrative mess for any doctor who doesn't have the luxury of a seasoned healthcare administrator in his office. Add to that the eligibility trouble. Multiple phone calls for every patient to check eligibility for every appointment. Worst of all, the current health insurance system provides no incentive to managed care to pay for preventive care.

These are the issues that single-payer would fix for the insured population, saving billions of dollars. Dr. Lebow is right on, though I wish he spent as much time on eligibility and insurance company hassles as he did on preventive care. He also does great work in presenting the myths of healthcare today. Many of them can't be repeated enough (like the corporate welfare given to prescription drug companies).

But I have several issues as well.

My biggest complaint is that his solution only delays the inevitable a little longer. He deals only with the healthcare funding system and has little to say about the healthcare delivery system. "Market Driven Healthcare" by Regina Herzlinger and "From Chaos to Care" by David Lawrence offer real long-term solutions to the healthcare delivery problems we face in our current environment. Unless those market principles are imposed on healthcare, single payor will only delay the final implosion of medical care. Once the financial gains from single-payor healthcare are realized and exhausted, the costs will continue to spiral out of control.

Another issue is that he gives few details in the "how" of his solutions. Focusing on prevention and public health is a good and obvious point. Everybody agrees on it, but I don't think simply saying "it will happen once a grassroots movement demands it" is sufficiently descriptive of how he sees prevention and public health becoming the standard. Who will implement it? How?

Because of these problems, Dr. Lebow does not make a convincing case to those in power that change is good for them. He persuades the persuaded brilliantly, but I can't imagine why someone who opposes single-payer would change his mind after reading this book. And those in power are whose minds must be changed if change is to come.

The way I see it, healthcare as we know it is a very young industry. Only 16 years ago, managed care was almost an unkown in the healthcare world. Now, it dominates. Unfortunately, that insurance model grew so quickly there was no way anyone could have planned it properly. Imagine how the computer industry would have destroyed itself if it weren't entirely made up of systems thinkers known for their planning ability. ISO-9000 was brilliant, as is settling on the PC as the standard. Healthcare needs, and is getting, more of that now. HIPAA and state-mandated credentialing applications perfectly demonstrate the government's role in fixing healthcare. It should be a regulator, an agent for the lowly to make sure the big guys play fair, and a standard-setter to make commercial insurance more efficient. But it's entirely too early to declare the market dead and single payer as the only way out of this mess.

As an Adjunct instructor in the Concordia University system, I have had the opportunity to encourage my MBA students to read this book for my Special Topics in Health care class. After reviewing other possible textbooks during the last 6 months, I have decided to now use this text as the basis for my 8-week adult education class. Offering ample examples and 'myths' that portray our fractured health care system of today, this author has summarily provided a springboard for ongoing conversations and possible answers for this country. Granted all, the HC system will not be corrected for some time, but an accounting will be made when the public becomes a focused participant at the table.
As health care professionals, it is our responsibility to study, learn, participate and educate others, as well as ourselves.
This will begin that process and it will be well worth your effort and consideration.
Thank you
ESchwarz, RN, MBA, CCM