THE TROUBLED HEALTH DOLLAR

Author and doctor of internal medicine Fredman offers a balanced collection of discussions about the health care system.

This easy-to-read book will thoroughly inform readers who want to know more about the U.S. health care system, how it started and the reasons behind its changes. Rather than pointing fingers at a particular plan or political party, Fredman rewinds to the early 1800s and examines the progression of health care. This approach sheds light on the way health care, like many other industries, has evolved into a “factory”-type system in which numerous workers handle fewer tasks; hence, the rise of physician assistants, nurses, nurse aides and more task-oriented jobs. Aside from facts and statistics, each chapter supplies anecdotes that illustrate changes in the industry, from emergency rooms to gynecological services to health care for minority groups like Native Americans and African-Americans. He also explores the intersection of the health care and legal systems, as malpractice shifts the types and frequency of certain procedures based on risk. Yet, Fredman doesn’t stop at just one side of the issue; instead, he examines how malpractice has been both good and bad for the progress of medical care, offering clear, reasonable explanations for his position. With chapters spanning medical procedure changes to the costs of medical education and technology, Fredman covers many sides of the complex equation that explains the rising cost of medical care. One chapter offers a surprising view of how patients facing terminal illness are “sold” a variety of solutions and treatment options by different doctors. Shopping for health care can be a confusing process when “experts” hold such differing views and opinions. Often, the best options are limited in supply, as they require expensive technology and formidable medical training. Ultimately, Fredman makes an argument about the feasibility of “Obamacare” and offers several solutions of his own to mitigate current kinks in the system. The book demonstrates just how complex health care has become and will enlighten and challenge readers who think there’s a quick fix rooted in budget balancing or privatization.

Well-researched and digestible.