new book

Why Not Better and Cheaper?

by James Rebitzer and Robert Rebitzer

An engaging account of innovation in healthcare and why it matters for patients and society.

The evolution of the cell phones we carry in our pockets demonstrates that quality can increase while prices fall. Why doesn't healthcare also get better and cheaper?

In Why Not Better and Cheaper?, James B. Rebitzer and Robert S. Rebitzer offer an answer to this question. Bringing together research on incentives, social norms, and market competition, they argue that the healthcare system generates the wrong kinds of innovation. It is too easy to profit from low-value innovations and too hard to profit from innovations that reduce the costs of care. The result is a healthcare system that is profusely innovative yet remarkably ineffective in discovering ways to deliver increased value at lower cost.

Why Not Better and Cheaper? sheds new light on the trajectory of innovation in healthcare, and how to point innovation in a better direction.

“In Why Not Better and Cheaper? James and Robert Rebitzer elegantly explain the misaligned incentives in American healthcare and how to fix them. This is a must-read for anyone looking to make healthcare better and cheaper.”
— Bob Kocher, M.D. Partner at Venrock. Former Special Assistant to President Obama for Healthcare and Economic Policy
“The book does not disappoint—it is a masterclass in medicine, law, economics, strategy, and psychology— infused with clever facts and written with a steadfast determination to make the reader smarter about taking health care, which is so doggedly frustrating and expensive, and innovating to make it Better and Cheaper.”
— Amitabh Chandra, Ethel Zimmerman Wiener Professor, Harvard Kennedy School of Government. Henry and Allison McCance Family Professor of Business Administration, Harvard Business School
“At last, a book that explains why a country with extraordinary innovative capacity has a wildly expensive and underperforming healthcare sector – and it’s not just the prices! The Brothers Rebitzer use fascinating examples to pinpoint the perverse incentives driving low-value innovation in the U.S. healthcare sector and to show what can be done to can set them right.”
— Leemore Dafny, Bruce V. Rauner Professor of Business Administration, Harvard Business School

More Endorsements

  • "The Rebitzers explore an overlooked feature of our healthcare system: it is too easy to profit from low-value innovations and too hard for cost-reducing innovations to find a buyer. The book is full of engaging examples and policy ideas. Anyone who cares about innovation in healthcare and wants to make things better should read it."

    David Cutler, Otto Eckstein Professor of Applied Economics, Harvard University

  • "This is a most welcome and important work on US health care. Two brothers, Jim and Bob Rebitzer, one an economist and one a business consultant, combine their unique perspectives to give us fresh and deep insights into why health care innovation in the US is the way it is and what we can do about it."

    Martin Gaynor, E.J. Barone University Professor of Economics and Public Policy, Carnegie Mellon University

  • "The promise of innovation is to provide better technologies at lower cost. But in health care markets, we often observe that ideas for potential cost-reducing innovations fail to take root, and never diffuse to benefit patients. In this fantastic book, Jim and Bob Rebitzer provide a compelling diagnosis of this problem and lay out a road map for how to fix it."

    Heidi Williams, Charles R. Schwab Professor of Economics at Stanford University

  • "A compelling analysis of a question that has long puzzled experts: why innovation does not reliably increase value in health care. Combining insights from economics with close inspection of the institutional features of the health care system, Why Not Better and Cheaper shines new light on this health policy conundrum. A must read for all who want to improve the American health system."

    Meredith Rosenthal, Boyden Gray Professor of Health Economics and Policy, T. H. Chan School of Public Health, Harvard University

  • "Jim and Bob Rebitzer present a compelling analysis about the sources of dysfunction in the American health care system. They combine a broad understanding of economics with deep knowledge of health care to explain why important innovations often have trouble spreading widely, while marginal ones can proliferate at ruinous prices. And their recommendations, involving incentives, creative application of professional norms, and thoughtfully-regulated competition, offer a useful and optimistic path forward."

    Mark Smith M.D., Founding President and CEO of the California Healthcare Foundation

  • "Why Not Better and Cheaper? shines a light on the remarkable anomaly that, unlike any other industry, innovation and value creation are often opposites in healthcare. The Rebitzers demonstrate this in fascinating and tangible ways, pointing out that meaningful advancements often struggle to see the light of day. An essential read for anyone in healthcare."

    Lisa Suennen, Venture Capitalist and Serial Entrepreneur

  • "In a highly readable way, the Rebitzers do a masterful job of synthesizing a vast amount of theory and practice to answer an important question: why we don’t have cost reducing innovation in healthcare. The answer lies in the incentives, norms and competitive structure of our complex, pluralistic, and highly profitable health system. They dissect the problem carefully and compellingly and offer cogent policy suggestions about how to get more healthcare and health for the money we spend. But even these innovations may not be enough to alter the course of a multi trillion dollar “Pimp My Ride” health system."

    Ian Morrison, Author, Consultant, Futurist