Students of health economics and policymakers will find the doctor’s diagnoses and prescriptions well worth considering.

WHICH COUNTRY HAS THE WORLD'S BEST HEALTH CARE?

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 13, 2020

Kirkus Reviews Issue: May 1, 2020

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A sweet-and-sour set of pieces on loss, absurdity, and places they intersect.

HAPPY-GO-LUCKY

Sedaris remains stubbornly irreverent even in the face of pandemic lockdowns and social upheaval.

In his previous collection of original essays, Calypso (2018), the author was unusually downbeat, fixated on aging and the deaths of his mother and sister. There’s bad news in this book, too—most notably, the death of his problematic and seemingly indestructible father at 96—but Sedaris generally carries himself more lightly. On a trip to a gun range, he’s puzzled by boxer shorts with a holster feature, which he wishes were called “gunderpants.” He plays along with nursing-home staffers who, hearing a funnyman named David is on the premises, think he’s Dave Chappelle. He’s bemused by his sister Amy’s landing a new apartment to escape her territorial pet rabbit. On tour, he collects sheaves of off-color jokes and tales of sexual self-gratification gone wrong. His relationship with his partner, Hugh, remains contentious, but it’s mellowing. (“After thirty years, sleeping is the new having sex.”) Even more serious stuff rolls off him. Of Covid-19, he writes that “more than eight hundred thousand people have died to date, and I didn’t get to choose a one of them.” The author’s support of Black Lives Matter is tempered by his interest in the earnest conscientiousness of organizers ensuring everyone is fed and hydrated. (He refers to one such person as a “snacktivist.”) Such impolitic material, though, puts serious essays in sharper, more powerful relief. He recalls fending off the flirtations of a 12-year-old boy in France, frustrated by the language barrier and other factors that kept him from supporting a young gay man. His father’s death unlocks a crushing piece about dad’s inappropriate, sexualizing treatment of his children. For years—chronicled in many books—Sedaris labored to elude his father’s criticism. Even in death, though, it proves hard to escape or laugh off.

A sweet-and-sour set of pieces on loss, absurdity, and places they intersect.

Pub Date: May 31, 2022

ISBN: 978-0-316-39245-7

Page Count: 272

Publisher: Little, Brown

Review Posted Online: March 11, 2022

Kirkus Reviews Issue: April 1, 2022

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A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...

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WHEN BREATH BECOMES AIR

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. 30, 2015

Kirkus Reviews Issue: Oct. 15, 2015

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