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 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
A philosophically rich critique of state violence and mass apathy.
An Egyptian Canadian journalist writes searchingly of this time of war.
“Rules, conventions, morals, reality itself: all exist so long as their existence is convenient to the preservation of power.” So writes El Akkad, who goes on to state that one of the demands of modern power is that those subject to it must imagine that some group of people somewhere are not fully human. El Akkad’s pointed example is Gaza, the current destruction of which, he writes, is causing millions of people around the world to examine the supposedly rules-governed, democratic West and declare, “I want nothing to do with this.” El Akkad, author of the novel American War (2017), discerns hypocrisy and racism in the West’s defense of Ukraine and what he views as indifference toward the Palestinian people. No stranger to war zones himself—El Akkad was a correspondent in Afghanistan and Iraq—he writes with grim matter-of-factness about murdered children, famine, and the deliberate targeting of civilians. With no love for Zionism lost, he offers an equally harsh critique of Hamas, yet another one of the “entities obsessed with violence as an ethos, brutal in their treatment of minority groups who in their view should not exist, and self-decreed to be the true protectors of an entire religion.” Taking a global view, El Akkad, who lives in the U.S., finds almost every government and society wanting, and not least those, he says, that turn away and pretend not to know, behavior that we’ve seen before and that, in the spirit of his title, will one day be explained away until, in the end, it comes down to “a quiet unheard reckoning in the winter of life between the one who said nothing, did nothing, and their own soul.”
A philosophically rich critique of state violence and mass apathy.Pub Date: Feb. 25, 2025
ISBN: 9780593804148
Page Count: 224
Publisher: Knopf
Review Posted Online: Dec. 14, 2024
Kirkus Reviews Issue: Jan. 15, 2025
BOOK REVIEW
BOOK REVIEW
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