America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System


Steven Brill - 2015
    It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation.   But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury. Praise for America’s Bitter Pill   “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times   “An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.” —The New York Times Book Review   “A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”—Los Angeles Times  “A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”—The Daily Beast  “One of the most important books of our time.”—Walter Isaacson   “Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”—The New York Review of Books

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back


Elisabeth Rosenthal - 2017
    In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?Breaking down this monolithic business into the individual industries--the hospitals, doctors, insurance companies, and drug manufacturers--that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw.The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care


T.R. Reid - 2009
    R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost. In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid sees problems too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right?The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate: Is health care a human right?

Your Money or Your Life: Strong Medicine for America's Health Care System


David M. Cutler - 2003
    Medical care is in crisis, we are repeatedly told, and so it is. Barely one in five Americans thinks the medical system works well. Enter David M. Cutler, a Harvard economist who served on President Clinton's health care task force and later advised presidential candidate Bill Bradley. One of the nation's leading experts on the subject, Cutler argues in Your Money or Your Life that health care has in fact improvedexponentially over the last fifty years, and that the successes of our system suggest ways in which we might improve care, make the system easier to deal with, and extend coverage to all Americans. Cutler applies an economic analysis to show that our spending on medicine is well worth it--and thatwe could do even better by spending more. Further, millions of people with easily manageable diseases, from hypertension to depression to diabetes, receive either too much or too little care because of inefficiencies in the way we reimburse care, resulting in poor health and in some cases prematuredeath. The key to improving the system, Cutler argues, is to change the way we organize health care. Everyone must be insured for the medical system to perform well, and payments should be based on the quality of services provided not just on the amount of cutting and poking performed. Lively and compelling, Your Money or Your Life offers a realistic yet rigorous economic approach to reforming health care--one that promises to break through the stalemate of failed reform.

Chronic Condition: Why Canada's Health Care System Needs To Be Dragged Into The 21c


Jeffrey Simpson - 2012
    Touch it and you die. Every politician knows this truism, which is why no one wants to debate it. Privately, many of them understand that the health care system, which costs about $200 billion a year in public and private money, cannot continue as it is—increasingly ill-adapted to an aging population with public costs growing faster than government revenues. In Chronic Condition, Jeffrey Simpson meets health care head on and explores the only four options we have to end this growing crisis: cuts in spending, tax increases, privatization, and reaping savings through increased efficiency. He examines the tenets of the Medicare system that Canadians cling to so passionately. Here, he finds that many other countries have more extensive public health systems, and Canadian health care produces only average value for money. In fact, our rigid system for some health care needs and a costly system for other needs—drugs, dentistry, and home care—is really the worst of both worlds. Chronic Condition breaks the silence about the huge changes and real choices that Canadians face.

Best Care Anywhere: Why VA Health Care Is Better Than Yours


Phillip Longman - 2007
    This encouraging change not only has benefited veterans but also provides a blueprint for salvaging America's own deeply troubled healthcare system. "Best Care Anywhere" shows how a government bureaucracy, working with little notice, is setting the standard for best practices and cost reduction while the private sector is lagging in both areas. Author Phillip Longman challenges conventional wisdom by explaining exactly how market forces work to lower quality and raise prices in the healthcare sector, and how U.S. medical practices have a weak basis in science. The book, expanded from a widely praised article in the "Washington Monthly," mixes hard facts with author Philip Longmans' compelling human story of the loss of his wife to cancer. Part manifesto, part moving memoir, "Best Care Anywhere" offers new hope for addressing a major problem of contemporary society that affects all of us.

Pandemics: Our Fears and the Facts (Kindle Single)


Sunetra Gupta - 2013
    As recently as 1918, a pandemic of influenza claimed over 50 million lives worldwide. The advent of drugs and vaccines led to an era of hope when we thought our battles with infectious disease were won, but our optimism has been eroded by the recognition that many pathogens have the capacity to transform themselves and escape our efforts to eradicate them. Are we now facing an inevitable repeat of a calamity such as the 1918 influenza pandemic or the Black Death? Can we anticipate and thwart such an event, or are we wilfully creating the conditions that would promote the emergence of new and highly virulent human infectious disease?Sunetra Gupta is Professor of Theoretical Epidemiology at the University of Oxford specialising in infectious diseases. She holds a bachelor's degree from Princeton University and a Ph.D. from the University of London. She has been awarded the Scientific Medal by the Zoological Society of London and the Royal Society Rosalind Franklin Award for her scientific research. She is also a novelist whose books have been awarded the Sahitya Akademi Award, the Southern Arts Literature Prize, shortlisted for the Crossword Award, and longlisted for the DSC and Orange Prizes.

Affordable Excellence: The Singapore Healthcare Story


William A. Haseltine - 2012
    Singapore ranks sixth in the world in healthcare outcomes, yet spends proportionally less on healthcare than any other high-income country. This is the first book to set out a comprehensive system-level description of healthcare in Singapore, with a view to understanding what can be learned from its unique system design and development path.The lessons from Singapore will be of interest to those currently planning the future of healthcare in emerging economies, as well as those engaged in the urgent debates on healthcare in the wealthier countries faced with serious long-term challenges in healthcare financing. Policymakers, legislators, public health officials responsible for healthcare systems planning, finance and operations, as well as those working on healthcare issues in universities and think tanks should understand how the Singapore system works to achieve affordable excellence.

Who Killed Healthcare?: America's $2 Trillion Medical Problem - And the Consumer-Driven Cure: America's $1.5 Trillion Dollar Medical Problem--And the Consumer-Driven Cure


Regina Herzlinger - 2007
    health care, patients and doctors are losing. Who Killed Health Care? shows how to win the war. One of the nation's most respected health care analysts, Regina Herzlinger exposes the motives and methods of those who have crippled America's health care system-figures in the insurance, hospital, employment, governmental, and academic sectors. She proves how our current system, which is organized around payers and providers rather than the needs of its users, is dangerously eroding patient welfare and is pushing costs out of the reach of millions.Who Killed Health Care? then outlines Herzlinger's bold new plan for a consumer-driven system that will deliver affordable, high-quality care to everyone. By putting insurance money in the hands of patients, removing the middleman in the doctor-patient relationship, and giving employers cost relief, consumers and physicians will be empowered to make the system work the way it should. Herzlinger describes in precise detail how her innovative program will provideSmaller, disease-focused medical facilities that provide complete care for patientsA national system of medical records that provides privacy with confidential access by approved practitionersMandatory performance evaluations of all hospitals and all other medical organizationsMandatory health insurance with subsidies for those who cannot afford itWho Killed Health Care? is a call to arms that must be answered; the welfare of every American hangs in the balance."A brilliant analysis... A must-read." - Bill George, Professor, Harvard Business School and Former CEO of Medtronic"As it becomes more and more obvious to everyone that our current health care system is unsustainable, this is the book that had to be written." - Daniel H. Johnson, Jr. MD, former president of the American Medical Association"Regina Herzlinger's ideas to tackle the crisis of the U.S. health care system are based on keen knowledge of the system's existing difficulties along with insights that introduce the reader to new streamlined choices that have the potential of getting both quantity and cost under control." - Joseph Kennedy, founder, chairman, and president, Citizens Energy Corporation, CEO, Citizens Health Care, former representative (D-Mass)"Regina Herzlinger... offers a vision of the way things can be, should be, and will be sooner or later. The only question is: how long do we have to wait?" - Greg Scandlen, founder, Consumers for Health Choices "Regi Herzlinger has brilliantly articulated a better way - embracing the principles of competition and innovation that cause every other sector of our economy to thrive. Discharging American health care from the ICU can only happen by putting individual Americans - not politicians and bureaucrats - back in charge of their health care decisioins." - U.S. Senator Tom Coburn (R-Okla), M.D. "Following on the heels of her landmark Market-Driven Health Care, Herzlinger lays it on the line with her expose of what many who work in the health care industry have felt in their gut. Now it is articulated in an entertaining and must-read portrayal, with you and me as the only way out." - Dennis White, executive vice president for strategic development, National Business Coalition on Health "A wonderful Orwellian romp through issues which carry a deadly irony. The killers of health care are, of course, the third parties, each of which has an itchy palm and a commitment to profit or power which exceeds the commitment to service, with each engaging the others within a politically shaped box. Rarely has the case for the public been made with so much force, foresight, and wit, and a better way forward shown so clearly." - James F. Fries, MD, Professor of Medicine, Stanford University School of Medicine "You can practically hear the war chants as Professor Herzlinger sets out her view of what's wrong with the health care system and how to fix it. You'd best read it so you can decide which side you will be on when the battle is joined." - Paul Levy, CEO, Beth Israel Hospital, Boston, MA "Regina Herzlinger, the nation's leading expert on consumer-driven health care, has given us a brilliant analysis of the flaws in our health care system and what it will take to get it back on track. Her latest book is a must-read." - Bill George, Professor of Management Practice, Harvard Business School, Former CEO, Medtronic, and author of Authentic Leadership "You don't have to agree with her diagnosis and prescription for the U.S. health care system, but you do have to read her book. Once again, Professor Herzlinger has put together a well researched, well written, and very provocative blueprint for the future of health care." Peter L. Slavin, MD, President, Massachusetts General Hospital

Priced Out: The Economic and Ethical Costs of American Health Care


Uwe Reinhardt - 2019
    Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's U.S. health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.The problem, Reinhardt says, is not one of economics but of social ethics. There is no American political consensus on a fundamental question other countries settled long ago: to what extent should we be our brothers' and sisters' keepers when it comes to health care? Drawing on the best evidence, he guides readers through the chaotic, secretive, and inefficient way America finances health care, and he offers a penetrating ethical analysis of recent reform proposals. At this point, he argues, the United States appears to have three stark choices: the government can make the rich help pay for the health care of the poor, ration care by income, or control costs. Reinhardt proposes an alternative path: that by age 26 all Americans must choose either to join an insurance arrangement with community-rated premiums, or take a chance on being uninsured or relying on a health insurance market that charges premiums based on health status.An incisive look at the American health care system, Priced Out dispels the confusion, ignorance, myths, and misinformation that hinder effective reform.

Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients


Ben Goldacre - 2012
    We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.

Inside National Health Reform


John E. McDonough - 2011
    Dr. John E. McDonough, DPH, a health policy expert who served as an advisor to the late Senator Edward Kennedy, provides a vivid picture of the intense effort required to bring this legislation into law. McDonough clearly explains the ACA’s inner workings, revealing the rich landscape of the issues, policies, and controversies embedded in the law yet unknown to most Americans. In his account of these historic events, McDonough takes us through the process from the 2008 presidential campaign to the moment in 2010 when President Obama signed the bill into law. At a time when the nation is taking a second look at the ACA, Inside National Health Reform provides the essential information for Americans to make informed judgments about this landmark law.

The Premonition: A Pandemic Story


Michael Lewis - 2021
    But the president insisted there was nothing to worry about.Fortunately, we are still a nation of skeptics. Fortunately, there are those among us who study pandemics and are willing to look unflinchingly at worst-case scenarios. Michael Lewis’s taut and brilliant nonfiction thriller pits a band of medical visionaries against the wall of ignorance that was the official response of the Trump administration to the outbreak of COVID-19.The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society. A secret team of dissenting doctors, nicknamed the Wolverines, has everything necessary to fight the pandemic: brilliant backgrounds, world-class labs, prior experience with the pandemic scares of bird flu and swine flu…everything, that is, except official permission to implement their work.Michael Lewis is not shy about calling these people heroes for their refusal to follow directives that they know to be based on misinformation and bad science. Even the internet, as crucial as it is to their exchange of ideas, poses a risk to them. They never know for sure who else might be listening in.

The Health Gap: The Challenge of an Unequal World


Michael G. Marmot - 2015
    The same twenty-year avoidable disparity exists in the Calton and Lenzie neighborhoods of Glasgow, and in other cities around the world.In Sierra Leone, one in 21 fifteen-year-old women will die in her fertile years of a maternal-related cause; in Italy, the figure is one in 17,100; but in the United States, which spends more on healthcare than any other country in the world, it is one in 1,800. Why?Dramatic differences in health are not a simple matter of rich and poor; poverty alone doesn't drive ill health, but inequality does. Indeed, suicide, heart disease, lung disease, obesity, and diabetes, for example, are all linked to social disadvantage. In every country, people at relative social disadvantage suffer health disadvantage and shorter lives. Within countries, the higher the social status of individuals, the better their health. These health inequalities defy the usual explanations. Conventional approaches to improving health have emphasized access to technical solutions and changes in the behavior of individuals, but these methods only go so far. What really makes a difference is creating the conditions for people to have control over their lives, to have the power to live as they want. Empowerment is the key to reducing health inequality and thereby improving the health of everyone. Marmot emphasizes that the rate of illness of a society as a whole determines how well it functions; the greater the health inequity, the greater the dysfunction.Marmot underscores that we have the tools and resources materially to improve levels of health for individuals and societies around the world, and that to not do so would be a form of injustice. Citing powerful examples and startling statistics ("young men in the U.S. have less chance of surviving to sixty than young men in forty-nine other countries"), The Health Gap presents compelling evidence for a radical change in the way we think about health and indeed society, and inspires us to address the societal imbalances in power, money, and resources that work against health equity.

The Hospital: Life, Death, and Dollars in a Small American Town


Brian Alexander - 2021
    Americans are dying sooner, and living in poorer health. Alexander argues that no plan will solve America’s health crisis until the deeper causes of that crisis are addressed. Bryan, Ohio's hospital, is losing money, making it vulnerable to big health systems seeking domination and Phil Ennen, CEO, has been fighting to preserve its independence. Meanwhile, Bryan, a town of 8,500 people in Ohio’s northwest corner, is still trying to recover from the Great Recession. As local leaders struggle to address the town’s problems, and the hospital fights for its life amid a rapidly consolidating medical and hospital industry, a 39-year-old diabetic literally fights for his limbs, and a 55-year-old contractor lies dying in the emergency room. With these and other stories, Alexander strips away the wonkiness of policy to reveal Americans’ struggle for health against a powerful system that’s stacked against them, but yet so fragile it blows apart when the pandemic hits. Culminating with COVID-19, this book offers a blueprint for how we created the crisis we're in.