An indignant, urgent indictment of the for-profit American way of medical care.
A dispiriting look at the replacement of the Hippocratic oath by a PIN number that centers on the big business of kidney dialysis.
Basing his account on interviews with hundreds of constituents of the “dialysis community,” journalist Mueller, author of Extra Virginity and Crisis of Conscience, describes a health care industry that is seemingly entirely focused on profit. Most dialysis takes place at clinics where a premium is placed on getting patients in and out quickly, with the withdrawal and reinsertion of blood occurring more rapidly than the body can comfortably accommodate—even though in many instances, “when administered this way, dialysis may shorten patients’ lives by stripping off bodily fluids too fast, triggering sudden drops in blood pressure that can damage the heart, brain, gut, and lungs and lead to stroke, congestive heart failure, and cardiac arrest.” If you complain, you’re likely to be denied care—and, worse, far too many nephrologists are disinclined to fight on behalf of their patients. One nephrologist recounts that a colleague told her he had developed “techniques for goading undesirable patients into acting out, in order to eject them from his facility.” Most of these patients are insured by Medicare or Medicaid, a system that pays less than private insurance. Against the American system of “bazooka dialysis,” most advanced countries use a slower, more frequent program of dialysis. Furthermore, many of them place the locus of dialysis at home, with patients self-administering their care, a method that the American medical system lobbied hard to discourage. Some American physicians are bucking the system, Mueller writes, and the Trump administration issued an executive order demanding improved care—likely only because, Mueller ventures, Health and Human Services Secretary Alex Azar’s father “had been on dialysis for several years.” Even so, the system remains a mess, and bad actors are seldom punished.
An indignant, urgent indictment of the for-profit American way of medical care.Pub Date: Aug. 1, 2023
ISBN: 9780393866513
Page Count: 288
Publisher: Norton
Review Posted Online: June 28, 2023
Kirkus Reviews Issue: Aug. 1, 2023
BOOK REVIEW
BOOK REVIEW
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...
A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.
The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.Pub Date: Nov. 1, 2011
ISBN: 978-0-374-27563-1
Page Count: 512
Publisher: Farrar, Straus and Giroux
Review Posted Online: Sept. 3, 2011
Kirkus Reviews Issue: Sept. 15, 2011
BOOK REVIEW
IN THE NEWS
IN THE NEWS
These are not hard and fast rules, but Meyer delivers important reading for those engaged in international business.
A helpful guide to working effectively with people from other cultures.
“The sad truth is that the vast majority of managers who conduct business internationally have little understanding about how culture is impacting their work,” writes Meyer, a professor at INSEAD, an international business school. Yet they face a wider array of work styles than ever before in dealing with clients, suppliers and colleagues from around the world. When is it best to speak or stay quiet? What is the role of the leader in the room? When working with foreign business people, failing to take cultural differences into account can lead to frustration, misunderstanding or worse. Based on research and her experiences teaching cross-cultural behaviors to executive students, the author examines a handful of key areas. Among others, they include communicating (Anglo-Saxons are explicit; Asians communicate implicitly, requiring listeners to read between the lines), developing a sense of trust (Brazilians do it over long lunches), and decision-making (Germans rely on consensus, Americans on one decider). In each area, the author provides a “culture map scale” that positions behaviors in more than 20 countries along a continuum, allowing readers to anticipate the preferences of individuals from a particular country: Do they like direct or indirect negative feedback? Are they rigid or flexible regarding deadlines? Do they favor verbal or written commitments? And so on. Meyer discusses managers who have faced perplexing situations, such as knowledgeable team members who fail to speak up in meetings or Indians who offer a puzzling half-shake, half-nod of the head. Cultural differences—not personality quirks—are the motivating factors behind many behavioral styles. Depending on our cultures, we understand the world in a particular way, find certain arguments persuasive or lacking merit, and consider some ways of making decisions or measuring time natural and others quite strange.
These are not hard and fast rules, but Meyer delivers important reading for those engaged in international business.Pub Date: May 27, 2014
ISBN: 978-1-61039-250-1
Page Count: 288
Publisher: PublicAffairs
Review Posted Online: April 15, 2014
Kirkus Reviews Issue: May 1, 2014
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