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 19, 2010
Kirkus Reviews Issue: April 15, 1994
Useful but disappointingly commonplace tips.
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: Sept. 30, 2013
Kirkus Reviews Issue: Oct. 15, 2013
BOOK REVIEW
BOOK REVIEW
Oncologist Agus (Medicine and Engineering/Univ. of Southern California) predicts that the application of advanced technology for modeling complex systems will transform 21st-century medicine.
The author writes that a remark Nobel Laureate Murray Gell-Mann made to him in 2009—“Look at cancer as a system"—transformed the way he views his own specialty and the entire field of preventative medicine. It made him realize that “[r]ather than honoring the body as the exceedingly complex system that it is, we keep looking for the individual gene that has gone awry, or for the one ‘secret’ that can improve our health.” Agus writes that although the ability to sequence the entire human genome is a great step forward, it is insufficient for achieving a significant breakthrough. Even though it may start with a mutation, cancer “is a dynamic process that's happening…far from the confines of a static piece of DNA”—it involves the body's immune system, its ability to regulate cell growth, metabolism and more. Agus directs his university’s Center for Applied Molecular Medicine and is the co-founder of two personalized medicine companies, Applied Proteomics and Navigenics. His hope is that their research will contribute to developing better analytical tools for preventative medicine and for the treatment of cancers. These will address the functioning of the body as a whole, applying digital technology already used by physicists to provide virtual models of cancers and model the action of proteins that regulate cell communication in the body. He also hopes to develop tools that will provide information on the concentration of different proteins in a drop of blood taken from a patient, which may reveal the onset of disease. The author also includes some guiding principles and warnings about certain healthy practices that may not be so healthy. A refreshing change of pace in the medical field, but by venturing beyond his field of expertise to pontificate on a wide range of subjects, Agus makes his otherwise intriguing narrative difficult to follow.
Pub Date: Jan. 1, 2012
ISBN: 978-1-4516-1017-8
Page Count: 288
Publisher: Free Press
Review Posted Online: Nov. 5, 2011
Kirkus Reviews Issue: Nov. 15, 2011
BOOK REVIEW
BOOK REVIEW
© Copyright 2024 Kirkus Media LLC. All Rights Reserved.
Follow
Popular in this Genre
We can’t wait for you to join Kirkus!
It’s free and takes less than 10 seconds!
Already have an account? Log in.
OR
Sign in with GoogleTrouble signing in? Retrieve credentials.
Welcome Back!
OR
Sign in with GoogleTrouble signing in? Retrieve credentials.
bookshelf