A scathing denouncement, stronger in portraying the system’s problems than in offering pragmatic solutions.
A blast across the bow of the entire health care industry, which “attends more or less single-mindedly to its own profits.”
Rosenthal, a senior writer for the New York Times who has a Harvard Medical School degree and served as a physician at New York-Presbyterian Hospital, asserts that the American medical system is sick, having lost its focus on health. In the introduction, her list of “Economic Rules of the Dysfunctional Medical Market” includes such gems as “1. More treatment is always better. Default to the most expensive option,” and “10. Prices will rise to whatever the market will bear.” She begins by demonstrating how for-profit insurance changed the way hospitals operate and doctors practice medicine and how it has revolutionized the pharmaceutical and medical device industries. Throughout, the author blends extensive research with human interest. A personal horror story, with names and dates, opens each chapter: an individual dies or nearly dies, someone is overtreated, or someone receives a staggering bill for a simple test or procedure. In forthright language—Rosenthal uses blunt terms like “crapshoot” and “mess”—individual chapters focus in turn on hospitals, physicians, pharmaceuticals, medical devices, testing, and assorted medical business such as billing, coding, and collection agencies. One or more of the 10 “Economic Rules” sums up each presentation, driving home the author’s message of a deeply flawed medical-industrial system. Rosenthal then offers advice to patients on how to make the system more responsive and affordable. Beyond that, she details what changes society could and should demand through updates of regulations and laws. Five appendices provide further guidance, including a glossary of terms used in medical billing, sources of information on the internet about doctors, hospitals, procedures, and drugs, and templates for concise and effective protest letters.
A scathing denouncement, stronger in portraying the system’s problems than in offering pragmatic solutions.Pub Date: April 11, 2017
ISBN: 978-1-59420-675-7
Page Count: 416
Publisher: Penguin Press
Review Posted Online: Feb. 12, 2017
Kirkus Reviews Issue: March 1, 2017
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
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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