HEALTH AGAINST WEALTH

HMOS AND THE BREAKDOWN OF MEDICAL TRUST

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 20, 2010

Kirkus Reviews Issue: Sept. 1, 1996

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BEATING THE STREET

More uncommonly sensible investment guidance from a master of the game. Drawing on his experience at Fidelity's Magellan Fund, a high- profile vehicle he quit at age 46 in 1990 after a spectacularly successful 13-year tenure as managing director, Lynch (One Up on Wall Street, 1988) makes a strong case for common stocks over bonds, CDs, or other forms of debt. In breezy, anecdotal fashion, the author also encourages individuals to go it alone in the market rather than to bank on money managers whose performance seldom justifies their generous compensation. With the caveat that there's as much art as science to picking issues with upside potential, Lynch commends legwork and observation. ``Spending more time at the mall,'' he argues, invariably is a better way to unearth appreciation candidates than relying on technical, timing, or other costly divining services prized by professionals. The author provides detailed briefings on how he researches industries, special situations, and mutual funds. Particularly instructive are his candid discussions of where he went wrong as well as right in his search for undervalued securities. Throughout the genial text, Lynch offers wry, on-target advisories under the rubric of ``Peter's Principles.'' Commenting on the profits that have accrued to those acquiring shares in enterprises privatized by the British government, he notes: ``Whatever the Queen is selling, buy it.'' In praise of corporate parsimony, the author suggests that, ``all else being equal, invest in the company with the fewest photos in the annual report.'' Another bull's-eye for a consummate pro, with appeal for market veterans and rookies alike. (Charts and tabular material— not seen.)

Pub Date: March 1, 1993

ISBN: 0-671-75915-9

Page Count: 320

Publisher: Simon & Schuster

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: Jan. 1, 1993

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An absorbing, wide-ranging story of humans’ relationship with the water.

WHY WE SWIM

A study of swimming as sport, survival method, basis for community, and route to physical and mental well-being.

For Bay Area writer Tsui (American Chinatown: A People's History of Five Neighborhoods, 2009), swimming is in her blood. As she recounts, her parents met in a Hong Kong swimming pool, and she often visited the beach as a child and competed on a swim team in high school. Midway through the engaging narrative, the author explains how she rejoined the team at age 40, just as her 6-year-old was signing up for the first time. Chronicling her interviews with scientists and swimmers alike, Tsui notes the many health benefits of swimming, some of which are mental. Swimmers often achieve the “flow” state and get their best ideas while in the water. Her travels took her from the California coast, where she dove for abalone and swam from Alcatraz back to San Francisco, to Tokyo, where she heard about the “samurai swimming” martial arts tradition. In Iceland, she met Guðlaugur Friðþórsson, a local celebrity who, in 1984, survived six hours in a winter sea after his fishing vessel capsized, earning him the nickname “the human seal.” Although humans are generally adapted to life on land, the author discovered that some have extra advantages in the water. The Bajau people of Indonesia, for instance, can do 10-minute free dives while hunting because their spleens are 50% larger than average. For most, though, it’s simply a matter of practice. Tsui discussed swimming with Dara Torres, who became the oldest Olympic swimmer at age 41, and swam with Kim Chambers, one of the few people to complete the daunting Oceans Seven marathon swim challenge. Drawing on personal experience, history, biology, and social science, the author conveys the appeal of “an unflinching giving-over to an element” and makes a convincing case for broader access to swimming education (372,000 people still drown annually).

An absorbing, wide-ranging story of humans’ relationship with the water.

Pub Date: April 14, 2020

ISBN: 978-1-61620-786-1

Page Count: 288

Publisher: Algonquin

Review Posted Online: Jan. 5, 2020

Kirkus Reviews Issue: Feb. 1, 2020

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