A detailed and innovative blueprint for fixing what ails American medicine.
Time to radically revamp the American health care system in light of the flawed response to the Covid-19 pandemic and many other dysfunctions, argues this sweeping manifesto.
Kapur, a public policy professor at the University of Maryland College Park, and debut author Chalil, a physician and chairman of the Indo American Press Club, start by noting medical difficulties faced by the United States during the Covid-19 pandemic. These include shortages of masks, personal protective equipment, and ventilators; mass layoffs that caused people to lose their insurance; and bankruptcies among some hospitals that suspended elective procedures to make way for virus cases. They continue with a wide-ranging critique of American medicine, spotlighting its higher costs and poorer health outcomes compared to other developed countries; the lack of accessibility of needy and uninsured patients; shortages of hospitals, doctors, and nurses; and the pressure on providers to improve profits by cutting corners and to defend against malpractice suits with unnecessary tests. To remedy these problems, the authors propose a “Grand Plan To Restructure Healthcare in the U.S.” with a mix of public provisions and market-based competition. They envision a “SafetyNet” of public county hospitals providing basic care to all regardless of insurance or ability to pay. A second system of private hospitals, providers, and insurance, funded by “Enhanced Health Savings Accounts,” would run in parallel and compete in price and quality in a national and global market, with medical services advertised like groceries, complete with coupons. Other plan features include a unitary electronic medical record, caps on malpractice damages, a Comprehensive Consumer Healthcare Score that awards points for healthy lifestyles that could lower insurance rates, initiatives to train more health care professionals, a National Strategic Healthcare Reserve of emergency supplies, and new technologies, from online diagnosis to medical robots.
Kapur and Chalil present their case for far-reaching reforms of American health care in lucid prose that has an incisive bite. (“Calling it a healthcare system is a misnomer. It is a disease-care system, one that focuses on diagnosing and treating symptoms instead of taking on the job of educating individuals and families to take a proactive approach to their health.”) But the book suffers from a meandering, repetitive structure and an occasional lack of focus and rigor; it pursues tangents that some readers may consider dubious, like a brief for traditional Indian ayurvedic healing as an adjunct to Western medicine; and it sometimes gets facts wrong. (The 1918 Spanish flu did not kill “a third of the world’s population”—mortality was between 1% and 6%—and British Prime Minister Boris Johnson did not “support a herd immunity theory until he was hospitalized with the COVID-19 virus”; he imposed a national lockdown to prevent contagion on March 20, 2020, seven days before he tested positive.) The authors’ plan is something of a hodgepodge, with myriad moving parts to achieve many disparate goals, and it’s hazy on some important points, like the costs and funding mechanisms of the public SafetyNet hospitals. Still, Kapur and Chalil manage to steer clear of the dogmas of the right and left to offer a thoughtful, cogent analysis of the manifold problems in the U.S. health care establishment and a wealth of concrete proposals for dealing with them.
A detailed and innovative blueprint for fixing what ails American medicine.Pub Date: Oct. 5, 2020
ISBN: 978-1-7359048-0-1
Page Count: 276
Publisher: TheUNN Corporation
Review Posted Online: Feb. 8, 2021
Kirkus Reviews Issue: March 15, 2021
Review Program: Kirkus Indie
A clearly delineated guide to finally eradicate poverty in America.
A thoughtful program for eradicating poverty from the Pulitzer Prize–winning author of Evicted.
“America’s poverty is not for lack of resources,” writes Desmond. “We lack something else.” That something else is compassion, in part, but it’s also the lack of a social system that insists that everyone pull their weight—and that includes the corporations and wealthy individuals who, the IRS estimates, get away without paying upward of $1 trillion per year. Desmond, who grew up in modest circumstances and suffered poverty in young adulthood, points to the deleterious effects of being poor—among countless others, the precarity of health care and housing (with no meaningful controls on rent), lack of transportation, the constant threat of losing one’s job due to illness, and the need to care for dependent children. It does not help, Desmond adds, that so few working people are represented by unions or that Black Americans, even those who have followed the “three rules” (graduate from high school, get a full-time job, wait until marriage to have children), are far likelier to be poor than their White compatriots. Furthermore, so many full-time jobs are being recast as contracted, fire-at-will gigs, “not a break from the norm as much as an extension of it, a continuation of corporations finding new ways to limit their obligations to workers.” By Desmond’s reckoning, besides amending these conditions, it would not take a miracle to eliminate poverty: about $177 billion, which would help end hunger and homelessness and “make immense headway in driving down the many agonizing correlates of poverty, like violence, sickness, and despair.” These are matters requiring systemic reform, which will in turn require Americans to elect officials who will enact that reform. And all of us, the author urges, must become “poverty abolitionists…refusing to live as unwitting enemies of the poor.” Fortune 500 CEOs won’t like Desmond’s message for rewriting the social contract—which is precisely the point.
A clearly delineated guide to finally eradicate poverty in America.Pub Date: March 21, 2023
ISBN: 9780593239919
Page Count: 288
Publisher: Crown
Review Posted Online: Nov. 30, 2022
Kirkus Reviews Issue: Jan. 1, 2023
BOOK REVIEW
PERSPECTIVES
PERSPECTIVES
SEEN & HEARD
A master class in how gender has been weaponized in support of conservative values and authoritarian regimes.
A deeply informed critique of the malicious initiatives currently using gender as a political tool to arouse fear and strengthen political and religious institutions.
In their latest book, following The Force of Nonviolence, Butler, the noted philosopher and gender studies scholar, documents and debunks the anti-gender ideology of the right, the core principle of which is that male and female are natural categories whose recognition is essential for the survival of the family, nations, and patriarchal order. Its proponents reject “sex” as a malleable category infused with prior political and cultural understandings. By turning gender into a “phantasmatic scene,” they enable those in positions of authority to deflect attention from such world-destroying forces as war, predatory capitalism, and climate change. Butler explores the ideology’s presence in the U.S., the U.K., Uganda, and Hungary, countries where legislation has limited the rights of trans and homosexual people and denied them their sexual identity. The author also delves into the ideology’s roots among Evangelicals and the Catholic Church and such political leaders as Donald Trump and Viktor Orbán. Butler is particularly bothered by trans-exclusionary radical feminists (TERFs), who treat trans women as “male predators in disguise.” For the author, “the gap between the perceived or lived body and prevailing social norms can never be fully closed.” They imagine “a world where the many relations to being socially embodied that exist become more livable” and calls for alliances across differences and “a radical democracy informed by socialist values.” Butler compensates for the thinness of some of their recommendations with an astute dissection of the ideology’s core ideas and impressive grasp of its intellectual pretensions. This is a wonderfully thoughtful and impassioned book on a critically important centerpiece of contemporary authoritarianism and patriarchy.
A master class in how gender has been weaponized in support of conservative values and authoritarian regimes.Pub Date: March 19, 2024
ISBN: 9780374608224
Page Count: 320
Publisher: Farrar, Straus and Giroux
Review Posted Online: Dec. 5, 2023
Kirkus Reviews Issue: Jan. 1, 2024
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