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CARE EVOLUTION

ESSAYS ON HEALTH AS A SOCIAL IMPERATIVE

An intensive, mindful critique of modern health care that confronts its flaws and proposes solutions.

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A report on the complex social and economic issues that are hindering significant patient health care reforms.

Physician and former chief medical officer for Centria Healthcare Merahn’s collection of insightful essays focuses on his view that improvements to health care networks should be a “social imperative” in order to sustain educational and economic progress and avoid systemic inequities. The source of Merahn’s frustration stems from inaction from decision-makers and medical professionals to embrace patient-focused methods of care delivery. He sees health care as a critical necessity—one that’s battered by the forces of economic instability, racial injustice, unconscious bias, politics, and free market capitalist dynamics. Merahn’s research discovered many health care professionals who felt disconnected from their peers and lacking strategies to repair the devaluation of their occupation. The author takes a broad view of his subject, astutely examining the history of American health care and how it’s been incrementally destabilized by “those with less selfless and less generous agendas”; he also addresses how it’s been defined by revenue economics rather than by a philosophy of delivering quality communitywide care. The author writes that although the Covid-19 pandemic has successfully and swiftly mobilized crisis teams across the globe and, in most cases, amply supplied them with the resources they need, it’s also exposed a glaring lack of equitable access to care due in part to systemic racism. He notes that the crisis has also alarmingly revealed a distinct population with “deficient scientific literacy.”

Driven by what he perceives to be glaring systemic inadequacies, Merahn intelligently outlines an evolutionary plan that includes fundamental improvements in clinicians’ financial stability, an organizational restructuring of the care delivery system, and a revised vision of the kind of coverage and support that the American system should be providing. The author leaves little room for doubt that quality health care is urgently needed by everyone and that the system’s goals have, over time, become derailed by the desire for profit and are in need of a remedy that isn’t solely based on “how we pay for care" and is "more about how we plan for care.” Merahn advocates for increased human connection and noncategorical approaches to illness that, in his view, would “transcend diagnoses and acknowledge the power of emotion in influencing interactions in relationships.” Improved attention to patient dignity, integrity, and privacy are also key to this restructuring, he notes. The major thrust of his argument is based on the belief that health care should be free of doubt and confusion; because it’s become mired in these states, there needs to be a redesign and focused return to a “whole-person” frame of mind. Although the author’s medical industry rhetoric and densely rationalized arguments may sometimes be difficult for readers outside of clinical settings to grasp, his impassioned demands for change are unwaveringly convincing. Merahn’s persuasive call for action advocates for no less than an overhaul—one that redirects attention away from “networks of self-interest embedded throughout the healthcare ecosystem.”

An intensive, mindful critique of modern health care that confronts its flaws and proposes solutions.

Pub Date: Nov. 10, 2021

ISBN: 978-1-7359415-2-3

Page Count: 149

Publisher: Conversation Publishing

Review Posted Online: Aug. 17, 2021

Kirkus Reviews Issue: Oct. 15, 2021

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FOOTBALL

A smart, rewarding consideration of football’s popularity—and eventual downfall.

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A wide-ranging writer on his football fixation.

Is our biggest spectator sport “a practical means for understanding American life”? Klosterman thinks so, backing it up with funny, thought-provoking essays about TV coverage, ethical quandaries, and the rules themselves. Yet those who believe it’s a brutal relic of a less enlightened era need only wait, “because football is doomed.” Marshalling his customary blend of learned and low-culture references—Noam Chomsky, meet AC/DC—Klosterman offers an “expository obituary” of a game whose current “monocultural grip” will baffle future generations. He forecasts that economic and social forces—the NFL’s “cultivation of revenue,” changes in advertising, et al.—will end its cultural centrality. It’s hard to imagine a time when “football stops and no one cares,” but Klosterman cites an instructive precedent. Horse racing was broadly popular a century ago, when horses were more common in daily life. But that’s no longer true, and fandom has plummeted. With youth participation on a similar trajectory, Klosterman foresees a time when fewer people have a personal connection to football, rendering it a “niche” pursuit. Until then, the sport gives us much to consider, with Klosterman as our well-informed guide. Basketball is more “elegant,” but “football is the best television product ever,” its breaks between plays—“the intensity and the nothingness,” à la Sartre—provide thrills and space for reflection or conversation. For its part, the increasing “intellectual density” of the game, particularly for quarterbacks, mirrors a broader culture marked by an “ongoing escalation of corporate and technological control.” Klosterman also has compelling, counterintuitive takes on football gambling, GOAT debates, and how one major college football coach reminds him of “Laura Ingalls Wilder’s much‑loved Little House novels.” A beloved sport’s eventual death spiral has seldom been so entertaining.

A smart, rewarding consideration of football’s popularity—and eventual downfall.

Pub Date: Jan. 20, 2026

ISBN: 9780593490648

Page Count: 304

Publisher: Penguin Press

Review Posted Online: Oct. 24, 2025

Kirkus Reviews Issue: Dec. 1, 2025

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A PEOPLE'S HISTORY OF THE UNITED STATES

For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.

Pub Date: Jan. 1, 1979

ISBN: 0061965588

Page Count: 772

Publisher: Harper & Row

Review Posted Online: May 26, 2012

Kirkus Reviews Issue: Jan. 1, 1979

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