Hospital care is a crapshoot for most Americans, according to Pulitzer Prize-winning investigative journalist Bogdanich of The Wall Street Journal, who says here that the myth that all hospitals are equally good and deserving of our trust is medicine's ``great white lie.'' Bogdanich pulls no punches, naming hospitals, administrators, professional associations, doctors, nurses, technicians, and others in his thoroughly documented exposÇ. The problems are manifold—reliance on unqualified temporary help; improper training and supervision of pharmacy and lab technicians; life-threatening patient-discharge policies; and fraudulent billing practices. Competition among hospitals has even pushed some to bribe doctors for patients and to offer bonuses for meeting surgery quotas. Bogdanich cites the failure of the medical establishment to regulate hospitals, and faults the government for relying on such self-regulation. The Joint Commission on Accreditation of Healthcare Organizations, which rarely denies a hospital accreditation, comes in for some sharp criticism, as does the US Department of Health and Human Services, which Bogdanich asserts has recently been headed by people without will or vision. Although Medicare—the nation's largest buyer of hospital services—could dramatically reform care by reimbursing only those hospitals able to demonstrate high quality, prospects for change are poor. One solution Bogdanich explores is an effort by corporations in Cleveland, concerned about rising medical-insurance costs, to direct employees to the highest-quality, low-cost hospitals. In this instance, hospitals and businesses are working together to define and measure quality and by 1992 will be distributing information on quality and costs to employees. Meanwhile, Bogdanich counsels, if there's hospital care in your future, scrutinize it as carefully as you would any other prospective purchase. Hard-hitting and fact-filled indictment of a system overdue for reform. (Includes extensive source notes.)
Pub Date: Nov. 22, 1991
ISBN: 0-671-68452-3
Page Count: 320
Publisher: Simon & Schuster
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Oct. 1, 1991
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
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.
“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.
It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.Pub Date: Nov. 12, 2019
ISBN: 978-1-61039-950-0
Page Count: 432
Publisher: PublicAffairs
Review Posted Online: Aug. 28, 2019
Kirkus Reviews Issue: Sept. 15, 2019
SEEN & HEARD
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