Students of health economics and policymakers will find the doctor’s diagnoses and prescriptions well worth considering.
A leading oncologist and medical ethicist turns a gimlet eye on the health care systems of the world’s leading economies and finds most of them wanting.
Where’s the best place in the world to be sick? To judge by Emanuel’s findings, if you have a condition that will allow you to live awhile, the U.S. isn’t bad; it leads the world in medical innovations and finding cures or treatments for unusual ailments. By other measures, the U.S. ranks well down the list of the 11 systems he analyzes here: “It significantly underperforms on numerous dimensions,” writes the author. China may be worse, in part because its system of health care is hospital-centric: “There are vanishingly few physician offices or other ambulatory centers to deliver care.” Consequently, with the current COVID-19 crisis, Chinese people needing treatment flooded the country’s hospitals and overwhelmed them. In many parts of that country, Emanuel writes, hospitals are few and far between, forcing patients to travel far from home for treatment. Canadians have it better except in the remoter reaches of the far north; Emanuel acknowledges that Canadian health care has its problems even while noting that conservative critics in the U.S. have vastly overestimated the problem of waiting times for treatment. Britain’s system is worse but not terrible. The author offers numerous methods for improving systems around the world. Some may be unpalatable to libertarian advocates of privacy. For example, Taiwan was able to keep a lid, relatively speaking, on COVID-19, because medical data are centralized with passports and other key documents, so that it was easy to identify Taiwanese who had visited mainland China and test and, if necessary, quarantine them. Among Emanuel’s recommendations are to provide universal coverage, simplify data flows and insurance programs, and regulate drug prices—which are sky-high in the U.S.
Students of health economics and policymakers will find the doctor’s diagnoses and prescriptions well worth considering.Pub Date: June 16, 2020
ISBN: 978-1-5417-9773-4
Page Count: 256
Publisher: PublicAffairs
Review Posted Online: April 12, 2020
Kirkus Reviews Issue: May 1, 2020
BOOK REVIEW
BOOK REVIEW
Cogent, well-timed ideas for meeting today’s biggest challenges.
Helping liberals get out of their own way.
Klein, a New York Times columnist, and Thompson, an Atlantic staffer, lean to the left, but they aren’t interrogating the usual suspects. Aware that many conservatives have no interest in their opinions, the authors target their own side’s “pathologies.” Why do red states greenlight the kind of renewable energy projects that often languish in blue states? Why does liberal California have the nation’s most severe homelessness and housing affordability crises? One big reason: Liberal leadership has ensnared itself in a web of well-intentioned yet often onerous “goals, standards, and rules.” This “procedural kludge,” partially shaped by lawyers who pioneered a “democracy by lawsuit” strategy in the 1960s, threatens to stymie key breakthroughs. Consider the anti-pollution laws passed after World War II. In the decades since, homeowners’ groups in liberal locales have cited such statutes in lawsuits meant to stop new affordable housing. Today, these laws “block the clean energy projects” required to tackle climate change. Nuclear energy is “inarguably safer” than the fossil fuel variety, but because Washington doesn’t always “properly weigh risk,” it almost never builds new reactors. Meanwhile, technologies that may cure disease or slash the carbon footprint of cement production benefit from government support, but too often the grant process “rewards caution and punishes outsider thinking.” The authors call this style of governing “everything-bagel liberalism,” so named because of its many government mandates. Instead, they envision “a politics of abundance” that would remake travel, work, and health. This won’t happen without “changing the processes that make building and inventing so hard.” It’s time, then, to scrutinize everything from municipal zoning regulations to the paperwork requirements for scientists getting federal funding. The authors’ debut as a duo is very smart and eminently useful.
Cogent, well-timed ideas for meeting today’s biggest challenges.Pub Date: March 18, 2025
ISBN: 9781668023488
Page Count: 288
Publisher: Avid Reader Press
Review Posted Online: Jan. 16, 2025
Kirkus Reviews Issue: Feb. 15, 2025
BOOK REVIEW
PERSPECTIVES
SEEN & HEARD
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
PERSPECTIVES
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