A hard look at how for-profit health management organizations have come to be the force they are in our health care system and how their emphasis on the bottom line threatens quality medical care. Wall Street Journal reporter Anders (Merchants of Debt, 1992) reveals how corporations in the 1980s turned to managed care as a way to hold down the mushrooming costs of employee health plans by taking power away from doctors, hospitals, and patients and putting it in the hands of businessmen. Over 55 million Americans are now covered by HMOs, and their numbers are growing at the rate of 100,000 a week. The entrepreneurs who led the way in this astonishing revolution in our health care system come in for some sharp scrutiny (Anders seems to enjoy deploring their greed and flashy lifestyles), but the main focus is on how HMOs function. Anders examines their impact on hospitals, doctors, the pharmaceutical industry, and of course consumers. Hair-raising stories about the refusal to treat seriously ill patients are featured prominently in his discusion of how cost-conscious HMOs handle heart disease and breast cancer, emergency medicine, mental health, and care of the elderly and the poor. The picture that emerges is disheartening, even alarming, but not hopeless. Anders shows how consumers, doctors, employers, and regulators have been able in specific instances to challenge stingy treatment guidelines, negotiate for better access to specialists, change the rules about use of emergency rooms, and help set better standards of coverage. He concludes by summarizing various courses of action these groups can take to improve the medical care provided by HMOs and by warning HMOs that as society develops a cost-effective medical system, they may find themselves expendable. Highly readable and downright essential for anyone—patient or doctor—in an HMO or considering joining one. (Author tour)
Pub Date: Nov. 13, 1996
ISBN: 0-395-82283-1
Page Count: 288
Publisher: Houghton Mifflin
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Sept. 1, 1996
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
SEEN & HEARD
Career and business advice for the hashtag generation. For all its self-absorption, this book doesn’t offer much reflection...
A Dumpster diver–turned-CEO details her rise to success and her business philosophy.
In this memoir/business book, Amoruso, CEO of the Internet clothing store Nasty Gal, offers advice to young women entrepreneurs who seek an alternative path to fame and fortune. Beginning with a lengthy discussion of her suburban childhood and rebellious teen years, the author describes her experiences living hand to mouth, hitchhiking, shoplifting and dropping out of school. Her life turned around when, bored at work one night, she decided to sell a few pieces of vintage clothing on eBay. Fast-forward seven years, and Amoruso was running a $100 million company with 350 employees. While her success is admirable, most of her advice is based on her own limited experiences and includes such hackneyed lines as, “When you accept yourself, it’s surprising how much other people will accept you, too.” At more than 200 pages, the book is overlong, and much of what the author discusses could be summarized in a few tweets. In fact, much of it probably has been: One of the most interesting sections in the book is her description of how she uses social media. Amoruso has a spiritual side, as well, and she describes her belief in “chaos magic” and “sigils,” a kind of wishful-thinking exercise involving abstract words. The book also includes sidebars featuring guest “girlbosses” (bloggers, Internet entrepreneurs) who share equally clichéd suggestions for business success. Some of the guidance Amoruso offers for interviews (don’t dress like you’re going to a nightclub), getting fired (don’t call anyone names) and finding your fashion style (be careful which trends you follow) will be helpful to her readers, including the sage advice, “You’re not special.”
Career and business advice for the hashtag generation. For all its self-absorption, this book doesn’t offer much reflection or insight.Pub Date: May 6, 2014
ISBN: 978-0-399-16927-4
Page Count: 256
Publisher: Portfolio
Review Posted Online: June 22, 2014
Kirkus Reviews Issue: July 15, 2014
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