An engrossing, scholarly study that paints a sobering health care picture.
An economist offers an exhaustive condemnation of the American health care system in this nonfiction book.
With more than four decades of experience in health and retirement benefit plans, Schieber has an in-depth understanding of health care in America. In this voluminous, painstakingly researched work, he provides a historical perspective and current evaluation of the inner workings of the health care system, drawing on his own original explorations and other sources. His negative perspective is obvious: Part 1 is titled “Healthcare USA: A Cancer on the American Dream,” and Part 2 addresses “The Healthcare Provider Market and Exploitation of the Vulnerable.” In both parts, Schieber methodically dissects American health care, peppering readers with a dizzying array of facts and a wealth of statistical tables to support his argument. Part 1 examines health care in light of economic conditions from the 1980s through the 2010s. The controversial and highly politicized Affordable Care Act of 2010, aka Obamacare, does not escape the author’s critical eye. Schieber writes that while it did “improve access to care for many lower-income individuals and families,” the ACA “has provided little relief from excessive health care costs for people with employer-sponsored health insurance.” Part 2 delivers a bleak assessment of America’s health care costs at the provider level, taking into consideration hospitals, physicians, and pharmaceuticals. Schieber is at his best when referring to specific examples, such as his analysis of the development and pricing of insulin. In this part, the author notes that higher health costs are the result of more than just pricing issues; rather, he writes, they involve “widespread failure by almost every component” of the “health-industrial complex.” In Part 3, Schieber cites a 1975 study to dramatize the fact that the American health care system has basically not improved much since then. He recounts encouraging examples, such as Maryland’s testing of an alternative all-payer health program over five decades, as well as systems like Kaiser Permanente that are attempting to control costs. Still, it seems the primary purpose of this absorbing book is to indict American health care rather than propose specific solutions.
An engrossing, scholarly study that paints a sobering health care picture.Pub Date: Jan. 11, 2023
ISBN: 9781667878942
Page Count: 428
Publisher: BookBaby
Review Posted Online: Jan. 11, 2023
Review Program: Kirkus Indie
BOOK REVIEW
A short, smart analysis of perhaps the most famous passage in American history reveals its potency and unfulfilled promise.
Words that made a nation.
Isaacson is known for expansive biographies of great thinkers (and Elon Musk), but here he pens a succinct, stimulating commentary on the Founding Fathers’ ode to “life, liberty, and the pursuit of happiness.” His close reading of the Declaration of Independence’s second sentence, published to mark the 250th anniversary of the document’s adoption, doesn’t downplay its “moral contradiction.” Thomas Jefferson enslaved hundreds of people yet called slavery “a cruel war against human nature” in his first draft of the Declaration. All but 15 of the document’s 56 signers owned enslaved people. While the sentence in question asserted “all men are created equal” and possess “unalienable rights,” the Founders “consciously and intentionally” excluded women, Native Americans, and enslaved people. And yet the sentence is powerful, Isaacson writes, because it names a young nation’s “aspirations.” He mounts a solid defense of what ought to be shared goals, among them economic fairness, “moral compassion,” and a willingness to compromise. “Democracy depends on this,” he writes. Isaacson is excellent when explaining how Enlightenment intellectuals abroad influenced the founders. Benjamin Franklin, one of the Declaration’s “five-person drafting committee,” stayed in David Hume’s home for a month in the early 1770s, “discussing ideas of natural rights” with the Scottish philosopher. Also strong is Isaacson’s discussion of the “edits and tweaks” made to Jefferson’s draft. As recommended by Franklin and others, the changes were substantial, leaving Jefferson “distraught.” Franklin, who emerges as the book’s hero, helped establish municipal services, founded a library, and encouraged religious diversity—the kind of civic-mindedness that we could use more of today, Isaacson reminds us.
A short, smart analysis of perhaps the most famous passage in American history reveals its potency and unfulfilled promise.Pub Date: Nov. 18, 2025
ISBN: 9781982181314
Page Count: 80
Publisher: Simon & Schuster
Review Posted Online: Aug. 29, 2025
Kirkus Reviews Issue: Oct. 1, 2025
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
SEEN & HEARD
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
PERSPECTIVES
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