A well-intended but imperfectly constructed argument for community-based health care by a physician-turned–medical activist.
The Affordable Care Act of 2010, or Obamacare in shorthand, is a frequent target for the corporate right, offended at the thought that medicine should not be the profit center that, say, oil and copper afford. It is less often criticized by the left, which lends Singh’s (Arnhold Global Health Center, Mount Sinai) critique an interesting cry-in-the-wilderness quality. The author works from a by-now-quaint notion that the physician is the advocate for the patient and, more, that a doctor is a kind of “natural attorney for the poor.” In this advocacy, the physician must leverage existing networks not of insurers but of friends, neighbors, and family. Obesity, for instance, is a widespread problem everywhere in the United States but especially in poor neighborhoods, where nutrition is indifferent and healthy food not easily accessible. In such an instance, promoting good health practices to any effective measure involves remaking the community as much as the individual. Singh’s arguments against a health care regime “imbalanced in favor of technocrats and captains of industry” are very well-placed, as is his critique of ACA for, among other things, not including communities in health care planning or considering the neighborhood as a natural political unit; no one is better positioned to advance these arguments. Yet he is long in the diagnosis and short in the healing. While he states in many ways the basic notion that neighborhoods need to be engaged in health care, that community-based medicine needs to be made a priority, he is less cogent in advancing specific ways in which we can move toward “total population health,” as one of his chapter titles puts it, and shift medicine away from its current corporatized model.
Repetitive, somewhat circular pleading weakens the case, but Singh’s thesis merits discussion for anyone interested in curing a sick health care system.
Privately published by Strunk of Cornell in 1918 and revised by his student E. B. White in 1959, that "little book" is back again with more White updatings.
Stricter than, say, Bergen Evans or W3 ("disinterested" means impartial — period), Strunk is in the last analysis (whoops — "A bankrupt expression") a unique guide (which means "without like or equal").
Noted jazz and pop record producer Thiele offers a chatty autobiography. Aided by record-business colleague Golden, Thiele traces his career from his start as a ``pubescent, novice jazz record producer'' in the 1940s through the '50s, when he headed Coral, Dot, and Roulette Records, and the '60s, when he worked for ABC and ran the famous Impulse! jazz label. At Coral, Thiele championed the work of ``hillbilly'' singer Buddy Holly, although the only sessions he produced with Holly were marred by saccharine strings. The producer specialized in more mainstream popsters like the irrepressibly perky Teresa Brewer (who later became his fourth wife) and the bubble-machine muzak-meister Lawrence Welk. At Dot, Thiele was instrumental in recording Jack Kerouac's famous beat- generation ramblings to jazz accompaniment (recordings that Dot's president found ``pornographic''), while also overseeing a steady stream of pop hits. He then moved to the Mafia-controlled Roulette label, where he observed the ``silk-suited, pinky-ringed'' entourage who frequented the label's offices. Incredibly, however, Thiele remembers the famously hard-nosed Morris Levy, who ran the label and was eventually convicted of extortion, as ``one of the kindest, most warm-hearted, and classiest music men I have ever known.'' At ABC/Impulse!, Thiele oversaw the classic recordings of John Coltrane, although he is the first to admit that Coltrane essentially produced his own sessions. Like many producers of the day, Thiele participated in the ownership of publishing rights to some of the songs he recorded; he makes no apology for this practice, which he calls ``entirely appropriate and without any ethical conflicts.'' A pleasant, if not exactly riveting, memoir that will be of most interest to those with a thirst for cocktail-hour stories of the record biz. (25 halftones, not seen)