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REINVENTING AMERICAN HEALTH CARE

HOW THE AFFORDABLE CARE ACT WILL IMPROVE OUR TERRIBLY COMPLEX, BLATANTLY UNJUST, OUTRAGEOUSLY EXPENSIVE, GROSSLY INEFFICIENT, ERROR PRONE SYSTEM

An important challenge to the naysayers on both sides of the political divide.

Emanuel (Medical Ethics and Health Policy/Univ. of Pennsylvania; Brothers Emanuel: A Memoir of an American Family, 2013, etc.) views the Affordable Care Act as a success story.

The author, who serves as a special White House adviser on health care reform, is optimistic that its glitches will be resolved within the year and that it will transform how patients are cared for over the coming decades. He reprises the complex history of American health care policy beginning in 1942, when the National War Labor Board ruled that health insurance could be treated as a nontaxable fringe benefit despite the wage freeze. The later inclusion of Medicare and Medicaid increased the complexity of the system. Emanuel details the many inequities that developed—most notably, the exclusion of people with pre-existing health conditions from the system and the financial vulnerability of the uninsured, who also frequently receive substandard treatment—e.g.,“Being uninsured means your chance of dying in a car accident is 40% higher than that of a privately insured person.” The author asserts that the passage of the Affordable Care Act in 2010 “was a historic event,” especially in the context of the ongoing recession and political restraints, coupled with the need to deal with opposition from “physicians, insurers, and pharmaceutical manufacturers” and others. He offers an insider’s account of some of the infighting that occurred within the Obama administration, including his own altercations with his brother, Rahm, then chief of staff to the president. The author takes a long view of the reforms beginning with incentives and penalties for the adoption of uniform electronic health records in the 2009 Recovery Act. The ACA, he writes, “will increasingly be seen as a world historic achievement,” and “Barack Obama will be viewed more like Harry Truman—judged with increasing respect over time.”

An important challenge to the naysayers on both sides of the political divide.

Pub Date: March 4, 2014

ISBN: 978-1-61039-345-4

Page Count: 400

Publisher: PublicAffairs

Review Posted Online: Feb. 11, 2014

Kirkus Reviews Issue: March 1, 2014

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GOOD ECONOMICS FOR HARD TIMES

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.

It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.

Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.

Pub Date: Nov. 12, 2019

ISBN: 978-1-61039-950-0

Page Count: 432

Publisher: PublicAffairs

Review Posted Online: Aug. 28, 2019

Kirkus Reviews Issue: Sept. 15, 2019

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WHY WE SWIM

An absorbing, wide-ranging story of humans’ relationship with the water.

A study of swimming as sport, survival method, basis for community, and route to physical and mental well-being.

For Bay Area writer Tsui (American Chinatown: A People's History of Five Neighborhoods, 2009), swimming is in her blood. As she recounts, her parents met in a Hong Kong swimming pool, and she often visited the beach as a child and competed on a swim team in high school. Midway through the engaging narrative, the author explains how she rejoined the team at age 40, just as her 6-year-old was signing up for the first time. Chronicling her interviews with scientists and swimmers alike, Tsui notes the many health benefits of swimming, some of which are mental. Swimmers often achieve the “flow” state and get their best ideas while in the water. Her travels took her from the California coast, where she dove for abalone and swam from Alcatraz back to San Francisco, to Tokyo, where she heard about the “samurai swimming” martial arts tradition. In Iceland, she met Guðlaugur Friðþórsson, a local celebrity who, in 1984, survived six hours in a winter sea after his fishing vessel capsized, earning him the nickname “the human seal.” Although humans are generally adapted to life on land, the author discovered that some have extra advantages in the water. The Bajau people of Indonesia, for instance, can do 10-minute free dives while hunting because their spleens are 50% larger than average. For most, though, it’s simply a matter of practice. Tsui discussed swimming with Dara Torres, who became the oldest Olympic swimmer at age 41, and swam with Kim Chambers, one of the few people to complete the daunting Oceans Seven marathon swim challenge. Drawing on personal experience, history, biology, and social science, the author conveys the appeal of “an unflinching giving-over to an element” and makes a convincing case for broader access to swimming education (372,000 people still drown annually).

An absorbing, wide-ranging story of humans’ relationship with the water.

Pub Date: April 14, 2020

ISBN: 978-1-61620-786-1

Page Count: 288

Publisher: Algonquin

Review Posted Online: Jan. 4, 2020

Kirkus Reviews Issue: Feb. 1, 2020

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