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THE LONG FIX

SOLVING AMERICA'S HEALTH CARE CRISIS WITH STRATEGIES THAT WORK FOR EVERYONE

A health professional turns an experienced eye toward sensible, ground-level actions to make medical care better and cheaper.

Physician, scientist, and health care administrator Lee charts a new and improved system that lowers costs while providing more efficient service.

Lee, president of Health Platforms at Verily (formerly Google Life Sciences), is appalled by the current state of health care in the U.S., where spending is "rapidly approaching $4 trillion per year," far more than in countries that provide universal coverage—and our results are worse. In a nation in which 10% of citizens don’t have or can’t afford health insurance (and millions are underinsured), the landscape is dire: We waste 30 cents of every dollar spent on health care, 20% of medical care is unnecessary, medical errors are the third-leading cause of death, we forego preventative care, and we push high-cost, branded drugs instead of generics. Although Lee sometimes drifts into insurance-speak—"the Bundled Payments for Care Improvement pilot project"—she mostly presents sensible options: "Pay for results instead of action" (collaring costs, predicating fees for results); set expectations of zero tolerance for serious medical errors; giant providers (such as Medicare and the Veterans Health Administration) should negotiate prices; take cues from successful "employer-driven and government-run health systems"; and understand that it will take time to build "on the vital roles that everyone needs to play.” Lee believes that the fee-for-service models undercut doctors’ intrinsic motivations—such as purpose and mastery—and that it is crucial for patients to become fully engaged in their health care. Of particular value are the action plans that conclude each chapter, which contain countless helpful suggestions for patients, consumers, physicians, health care professionals, health care payers, and policymakers. These include tapping into big data (with buffers for privacy), a 10-point plan for employers, and a health system that learns from its results and acts on them.

A health professional turns an experienced eye toward sensible, ground-level actions to make medical care better and cheaper.

Pub Date: May 12, 2020

ISBN: 978-1-324-00667-1

Page Count: 256

Publisher: Norton

Review Posted Online: Feb. 25, 2020

Kirkus Reviews Issue: March 15, 2020

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WHY WE SWIM

An absorbing, wide-ranging story of humans’ relationship with the water.

A study of swimming as sport, survival method, basis for community, and route to physical and mental well-being.

For Bay Area writer Tsui (American Chinatown: A People's History of Five Neighborhoods, 2009), swimming is in her blood. As she recounts, her parents met in a Hong Kong swimming pool, and she often visited the beach as a child and competed on a swim team in high school. Midway through the engaging narrative, the author explains how she rejoined the team at age 40, just as her 6-year-old was signing up for the first time. Chronicling her interviews with scientists and swimmers alike, Tsui notes the many health benefits of swimming, some of which are mental. Swimmers often achieve the “flow” state and get their best ideas while in the water. Her travels took her from the California coast, where she dove for abalone and swam from Alcatraz back to San Francisco, to Tokyo, where she heard about the “samurai swimming” martial arts tradition. In Iceland, she met Guðlaugur Friðþórsson, a local celebrity who, in 1984, survived six hours in a winter sea after his fishing vessel capsized, earning him the nickname “the human seal.” Although humans are generally adapted to life on land, the author discovered that some have extra advantages in the water. The Bajau people of Indonesia, for instance, can do 10-minute free dives while hunting because their spleens are 50% larger than average. For most, though, it’s simply a matter of practice. Tsui discussed swimming with Dara Torres, who became the oldest Olympic swimmer at age 41, and swam with Kim Chambers, one of the few people to complete the daunting Oceans Seven marathon swim challenge. Drawing on personal experience, history, biology, and social science, the author conveys the appeal of “an unflinching giving-over to an element” and makes a convincing case for broader access to swimming education (372,000 people still drown annually).

An absorbing, wide-ranging story of humans’ relationship with the water.

Pub Date: April 14, 2020

ISBN: 978-1-61620-786-1

Page Count: 288

Publisher: Algonquin

Review Posted Online: Jan. 4, 2020

Kirkus Reviews Issue: Feb. 1, 2020

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THE RIGHT STUFF

Yes: it's high time for a de-romanticized, de-mythified, close-up retelling of the U.S. Space Program's launching—the inside story of those first seven astronauts.

But no: jazzy, jivey, exclamation-pointed, italicized Tom Wolfe "Mr. Overkill" hasn't really got the fight stuff for the job. Admittedly, he covers all the ground. He begins with the competitive, macho world of test pilots from which the astronauts came (thus being grossly overqualified to just sit in a controlled capsule); he follows the choosing of the Seven, the preparations for space flight, the flights themselves, the feelings of the wives; and he presents the breathless press coverage, the sudden celebrity, the glorification. He even throws in some of the technology. But instead of replacing the heroic standard version with the ring of truth, Wolfe merely offers an alternative myth: a surreal, satiric, often cartoony Wolfe-arama that, especially since there isn't a bit of documentation along the way, has one constantly wondering if anything really happened the way Wolfe tells it. His astronauts (referred to as "the brethren" or "The True Brothers") are obsessed with having the "right stuff" that certain blend of guts and smarts that spells pilot success. The Press is a ravenous fool, always referred to as "the eternal Victorian Gent": when Walter Cronkite's voice breaks while reporting a possible astronaut death, "There was the Press the Genteel Gent, coming up with the appropriate emotion. . . live. . . with no prompting whatsoever!" And, most off-puttingly, Wolfe presumes to enter the minds of one and all: he's with near-drowing Gus Grissom ("Cox. . . That face up there!—it's Cox. . . Cox knew how to get people out of here! . . . Cox! . . ."); he's with Betty Grissom angry about not staying at Holiday Inn ("Now. . . they truly owed her"); and, in a crude hatchet-job, he's with John Glenn furious at Al Shepard's being chosen for the first flight, pontificating to the others about their licentious behavior, or holding onto his self-image during his flight ("Oh, yes! I've been here before! And I am immune! I don't get into corners I can't get out of! . . . The Presbyterian Pilot was not about to foul up. His pipeline to dear Lord could not be clearer"). Certainly there's much here that Wolfe is quite right about, much that people will be interested in hearing: the P-R whitewash of Grissom's foul-up, the Life magazine excesses, the inter-astronaut tensions. And, for those who want to give Wolfe the benefit of the doubt throughout, there are emotional reconstructions that are juicily shrill.

But most readers outside the slick urban Wolfe orbit will find credibility fatally undermined by the self-indulgent digressions, the stylistic excesses, and the broadly satiric, anti-All-American stance; and, though The Right Stuff has enough energy, sass, and dirt to attract an audience, it mostly suggests that until Wolfe can put his subject first and his preening writing-persona second, he probably won't be a convincing chronicler of anything much weightier than radical chic.

Pub Date: Sept. 24, 1979

ISBN: 0312427565

Page Count: 370

Publisher: Farrar, Straus and Giroux

Review Posted Online: Oct. 13, 2011

Kirkus Reviews Issue: Sept. 1, 1979

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