Clear analysis of how our health care system came to be the way it is and what challenges lie ahead. Director since 1950 of Columbia University's Eisenhower Center for the Conservation of Human Resources, Ginzberg (Beyond Human Scale, 1985, etc.) describes the factors—unprecedented federal support for biomedical research, a greatly increased supply of physicians, hospital growth and modernization, and massive restructuring of health care financing—that have reshaped our health care system since WW II. He asserts that much is right with the present system: it offers clinical excellence, a high level of quality control, and, for most Americans, freedom of choice of physicians. Its flaws, however, are serious—the principal ones being lack of universal access to appropriate care and skyrocketing costs. These, plus numerous others—such as an imbalance between specialists and general practitioners, overuse of technology, and burdensome regulations—come under the author's scrutiny. Having concluded that the present system cannot long endure, he considers what must be done to fix it. The first priority is to ensure its future financial stability. Once that is accomplished, Ginzberg says, we can begin to strengthen the health-care delivery system- -i.e., provide universal access, reform medical education, consider alternative modes of physician practice, restructure hospital services, and deal with quality assurance problems. Ginzberg gives President Clinton high marks for tackling the two most pressing issues of cost control and universal access, but if there is one message he delivers, it is that the health-care system has many facets and that no single program can reform its multiplicity of problems. Valuable as an overview—despite a tendency to be repetitious and to oversimplify complex issues.
Pub Date: March 17, 1994
ISBN: 0-02-911715-1
Page Count: 192
Publisher: Free Press
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Feb. 1, 1994
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
The value of this book is the context it provides, in a style aimed at a concerned citizenry rather than fellow academics,...
A provocative analysis of the parallels between Donald Trump’s ascent and the fall of other democracies.
Following the last presidential election, Levitsky (Transforming Labor-Based Parties in Latin America, 2003, etc.) and Ziblatt (Conservative Parties and the Birth of Democracy, 2017, etc.), both professors of government at Harvard, wrote an op-ed column titled, “Is Donald Trump a Threat to Democracy?” The answer here is a resounding yes, though, as in that column, the authors underscore their belief that the crisis extends well beyond the power won by an outsider whom they consider a demagogue and a liar. “Donald Trump may have accelerated the process, but he didn’t cause it,” they write of the politics-as-warfare mentality. “The weakening of our democratic norms is rooted in extreme partisan polarization—one that extends beyond policy differences into an existential conflict over race and culture.” The authors fault the Republican establishment for failing to stand up to Trump, even if that meant electing his opponent, and they seem almost wistfully nostalgic for the days when power brokers in smoke-filled rooms kept candidacies restricted to a club whose members knew how to play by the rules. Those supporting the candidacy of Bernie Sanders might take as much issue with their prescriptions as Trump followers will. However, the comparisons they draw to how democratic populism paved the way toward tyranny in Peru, Venezuela, Chile, and elsewhere are chilling. Among the warning signs they highlight are the Republican Senate’s refusal to consider Barack Obama’s Supreme Court nominee as well as Trump’s demonization of political opponents, minorities, and the media. As disturbing as they find the dismantling of Democratic safeguards, Levitsky and Ziblatt suggest that “a broad opposition coalition would have important benefits,” though such a coalition would strike some as a move to the center, a return to politics as usual, and even a pragmatic betrayal of principles.
The value of this book is the context it provides, in a style aimed at a concerned citizenry rather than fellow academics, rather than in the consensus it is not likely to build.Pub Date: Jan. 16, 2018
ISBN: 978-1-5247-6293-3
Page Count: 320
Publisher: Crown
Review Posted Online: Nov. 12, 2017
Kirkus Reviews Issue: Dec. 1, 2017
BOOK REVIEW
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