BITTER MEDICINE

GREED AND CHAOS IN AMERICAN HEALTH CARE

Its subtitle notwithstanding, this is not a polemic but a cool and balanced analysis of our ailing health care system. An internist and journalist, Kassler (Gay Men's Health, 1983) approaches the system as though it were a patient—taking its history, noting its chief complaints, examining it, and then coming up with a diagnosis and plan of treatment. The history shows that the system underwent enormous change when third-party payers severed the connection between receiving care and paying for it. After identifying the system's chief complaints as spiraling costs, access problems, insurance hassles, the vanishing family doctor, and loss of privacy, Kassler examines the system's many players. First to come under her critical eye are the multitude of new industries spawned by the availability of huge funds from Medicare and Medicaid. Then she deftly probes the pharmaceutical industry; the medical profession; the media, especially for its part in boosting public demand for high-tech medical services; society's changing values; the government's multiple and complex roles; and the effects of the legal system. Her assessment is that the health care system is becoming too expensive and exclusionary and that we must create something stable, fair, and flexible. To do so, she says, requires setting some general goals: stabilize costs, provide universal care, ensure medical advances, take the anxiety out of the system. She proposes some broadly defined steps toward reaching these goals: pool our risks, maximize choice, move to community-based primary care, demedicalize social problems, separate insurance from employment. Her approach is holistic—working on all parts of the system to ``nudge all players toward reform.'' In a brief epilogue, she takes issue with many of the Clinton plan's specifics. Highly recommended—convincing and comprehensive.

Pub Date: June 1, 1994

ISBN: 1-55972-223-1

Page Count: 288

Publisher: Birch Lane Press

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: April 15, 1994

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Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...

THE IMMORTAL LIFE OF HENRIETTA LACKS

A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.

In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.

Pub Date: Feb. 9, 2010

ISBN: 978-1-4000-5217-2

Page Count: 320

Publisher: Crown

Review Posted Online: Dec. 22, 2010

Kirkus Reviews Issue: Jan. 1, 2010

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Useful but disappointingly commonplace tips.

A SHORT GUIDE TO A LONG LIFE

In a follow-up to The End of Illness (2012), which explored how technological advances will transform medicine, Agus (Medicine and Engineering/Univ. of Southern California) restates time-tested but too often overlooked principles for healthy living.

The author outlines simple measures that average citizens can take to live healthier lives and extend their life spans by taking advantage of modern technology to develop personalized records. These would include a list of medical tests and recommended treatments. Agus also suggests keeping track of indicators that can be observed at home on a regular basis—e.g., changes in energy, weight, appetite and blood pressure, blood sugar and general appearance. He advises that all of this information be made available online, and it is also helpful to investigate family history and consider DNA testing where indicated. Along with maintaining a healthy weight, Agus emphasizes the importance of eating a balanced diet, with plenty of fresh fruits and vegetables and a minimum of red meat. Avoid packaged vitamins and food supplements, and if possible, grow your own vegetables or buy frozen vegetables, which will generally be fresher than those on supermarket shelves. The author also warns against processed foods that make health claims but contain additives or excessive amounts of sugar or fat. Regular mealtimes and plenty of sleep, frequent hand-washing and oral hygiene are a must; smoking and excessive time in the sun should also be avoided. Agus recommends that adults should consider taking statins and baby aspirin as preventative measures. He concludes with a decade-by-decade checklist of annual medical examinations that should be routine—e.g. blood pressure, diabetes and cholesterol screenings, from one’s 20s on; colonoscopies, prostate exams and mammograms later—and a variety of top-10 lists (for example, “Top 10 Reasons to Take a Walk”).

Useful but disappointingly commonplace tips.

Pub Date: Jan. 7, 2014

ISBN: 978-1-4767-3095-0

Page Count: 128

Publisher: Simon & Schuster

Review Posted Online: Oct. 1, 2013

Kirkus Reviews Issue: Oct. 15, 2013

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