A serious, impassioned, and informed call for change.
In this authoritative survey of the biopharmaceutical industry, a scientist and investor diagnoses current problems and prescribes solutions.
Kolchinsky initially trained as a virologist, but he joined the biotechnology industry later on, and ever since, he says, he’s been on the “receiving end of a fire hose of knowledge.” He sees his current work as a biotech investor as providing a valuable contribution, but part of his book’s agenda is to state a mea culpa: “For too long my utopian view of the biotechnology industry omitted the perspective of patients who couldn’t afford their medications.” He then articulates what he calls the “Biotech Social Contract,” describing the relationship between the pharmaceutical industry and society. This contract would have the drug industry strive to make affordable versions of drugs (as generics) and have a health insurance industry providing universal coverage to keep costs down for patients. The author then enumerates the ways in which the contract has been breached by looking at the cryptic world of drug patents; how health insurance has the overburdened sick subsidize the more fortunate healthy; and the predatory practices of pharmacy benefit managers, who, according to the author, run “a complex shell game.” His main point is that although the biotech industry gets a bad rap for hunting big profits, it’s the insurance industry that’s the real problem; “drug companies must charge temporarily high prices for new drugs,” he argues, as long as their drugs go generic in a timely manner—but insurers, not patients, should bear that cost.
This meticulously organized and extensively supported book offers a thorough introduction to the factors and politics of drug pricing. In clear, deliberate prose, the author engages with and explains a range of concepts to lay readers. Even when Kolchinsky details rather elementary principles—one subsection is titled “How Insurance Is Supposed to Work”—he never strikes a condescending or pedantic tone. It’s hard not to share his ire toward insurance companies, although many readers may see his transfer of blame from the biotech industry and pharmaceutical companies to insurance providers as a self-serving maneuver. Still, his frustration with a dysfunctional system that allows patients to slip through a “patchwork of gaps” is unquestionably warranted. In the final chapter, he calls upon the biotech industry to continue linking revenue to innovation. This lacks the righteous punch of simply stating, “Let’s be ethical actors,” but the writer clearly knows that his industry has to uphold its end of the bargain. Kolchinsky stocks his pages with evidence, explanatory sidebars, and clarifications in regular footnotes. Sometimes, the most interesting point gets buried in the fine print. For instance, in one footnote, the author addresses a hot-button issue of the feasibility of a single-payer system. In the main text, he states that the single-payer model is “beyond the scope of this book,” but he expresses a firmer opinion in the footnote: “Basically, for a country the size of America, a single-payer system is likely only appealing in theory…but would be a tragedy of human incompetence in practice.”
A serious, impassioned, and informed call for change.Pub Date: Jan. 17, 2020
ISBN: 978-1-73305-891-9
Page Count: 292
Publisher: Evelexa Press
Review Posted Online: March 16, 2020
Kirkus Reviews Issue: April 15, 2020
Review Program: Kirkus Indie
An absorbing, wide-ranging story of humans’ relationship with the water.
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. 4, 2020
Kirkus Reviews Issue: Feb. 1, 2020
BOOK REVIEW
BOOK REVIEW
Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...
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
BOOK REVIEW
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