The Long Fix: Solving America's Health Care Crisis with Strategies that Work for Everyone


Vivian Lee - 2020
    This is bad for patients, bad for doctors, and bad for business.In The Long Fix, physician and health care CEO Vivian S. Lee, MD, cuts to the heart of the health care crisis. The problem with the way medicine is practiced, she explains, is not so much who’s paying, it’s what we are paying for. Insurers, employers, the government, and individuals pay for every procedure, prescription, and lab test, whether or not it makes us better—and that is both backward and dangerous.Dr. Lee proposes turning the way we receive care completely inside out. When doctors, hospitals, and pharmaceutical companies are paid to keep people healthy, care improves and costs decrease. Lee shares inspiring examples of how this has been done, from physicians’ practices that prioritize preventative care, to hospitals that adapt lessons from manufacturing plants to make them safer, to health care organizations that share online how much care costs and how well each physician is caring for patients.Using clear and compelling language, Dr. Lee paints a picture that is both realistic and optimistic. It may not be a quick fix, but her concrete action plan for reform—for employers and other payers, patients, clinicians, and policy makers—can reinvent health care, and create a less costly, more efficient, and healthier system for all.

Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans


Wendell Potter - 2010
    This former senior VP of CIGNA explained how health insurers make promises they have no intention of keeping, how they flout regulations designed to protect consumers, and how they skew political debate with multibillion-dollar PR campaigns designed to spread disinformation.Potter had walked away from a six-figure salary and two decades as an insurance executive because he could no longer abide the routine practices of an industry where the needs of sick and suffering Americans take a backseat to the bottom line. The last straw: when he visited a rural health clinic and saw hundreds of people standing in line in the rain to receive treatment in stalls built for livestock.In Deadly Spin, Potter takes readers behind the scenes to show how a huge chunk of our absurd healthcare spending actually bankrolls a propaganda campaign and lobbying effort focused on protecting one thing: profits. Whatever the fate of the current health care legislation, it makes no attempt to change that fundamental problem. Potter shows how relentless PR assaults play an insidious role in our political process anywhere that corporate profits are at stake-from climate change to defense policy. Deadly Spin tells us why-and how-we must fight back.

Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World


Tracy Kidder - 2003
    Doctor, Harvard professor, renowned infectious-disease specialist, anthropologist, the recipient of a MacArthur "genius" grant, world-class Robin Hood, Farmer was brought up in a bus and on a boat, and in medical school found his life’s calling: to diagnose and cure infectious diseases and to bring the lifesaving tools of modern medicine to those who need them most.Mountains Beyond Mountains takes us from Harvard to Haiti, Peru, Cuba, and Russia as Farmer changes minds and practices through his dedication to the philosophy that "the only real nation is humanity"—a philosophy that is embodied in the small public charity he founded, Partners in Health. He enlists the help of the Gates Foundation, George Soros, the U.N.’s World Health Organization, and others in his quest to cure the world. At the heart of this book is the example of a life based on hope, and on an understanding of the truth of the Haitian proverb "Beyond mountains there are mountains": as you solve one problem, another problem presents itself, and so you go on and try to solve that one too.

What the Eyes Don't See: A Story of Crisis, Resistance, and Hope in an American City


Mona Hanna-Attisha - 2018
    Mona Hanna-Attisha, alongside a team of researchers, parents, friends, and community leaders, discovered that the children of Flint, Michigan, were being exposed to lead in their tap water--and then battled her own government and a brutal backlash to expose that truth to the world. At the center of the story is Dr. Mona herself--an immigrant, doctor, scientist, and mother whose family's activist roots inspired her pursuit of justice.What the Eyes Don't See is a riveting account of a shameful disaster that became a tale of hope, the story of a city on the ropes that came together to fight for justice, self-determination, and the right to build a better world for their--and all of our--children.

American Overdose: The Opioid Tragedy in Three Acts


Chris McGreal - 2018
    But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers--resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.

The Patient Will See You Now: The Future of Medicine is in Your Hands


Eric J. Topol - 2015
    You'll make an appointment months in advance. You'll probably wait for several hours until you hear "the doctor will see you now"—but only for fifteen minutes! Then you'll wait even longer for lab tests, the results of which you'll likely never see, unless they indicate further (and more invasive) tests, most of which will probably prove unnecessary (much like physicals themselves). And your bill will be astronomical.In The Patient Will See You Now, Eric Topol, one of the nation’s top physicians, shows why medicine does not have to be that way. Instead, you could use your smartphone to get rapid test results from one drop of blood, monitor your vital signs both day and night, and use an artificially intelligent algorithm to receive a diagnosis without having to see a doctor, all at a small fraction of the cost imposed by our modern healthcare system.The change is powered by what Topol calls medicine's "Gutenberg moment." Much as the printing press took learning out of the hands of a priestly class, the mobile internet is doing the same for medicine, giving us unprecedented control over our healthcare. With smartphones in hand, we are no longer beholden to an impersonal and paternalistic system in which "doctor knows best." Medicine has been digitized, Topol argues; now it will be democratized. Computers will replace physicians for many diagnostic tasks, citizen science will give rise to citizen medicine, and enormous data sets will give us new means to attack conditions that have long been incurable. Massive, open, online medicine, where diagnostics are done by Facebook-like comparisons of medical profiles, will enable real-time, real-world research on massive populations. There's no doubt the path forward will be complicated: the medical establishment will resist these changes, and digitized medicine inevitably raises serious issues surrounding privacy. Nevertheless, the result—better, cheaper, and more human health care—will be worth it.Provocative and engrossing, The Patient Will See You Now is essential reading for anyone who thinks they deserve better health care. That is, for all of us.

Our Malady: Lessons in Liberty from a Hospital Diary


Timothy Snyder - 2020
    Unable to stand, barely able to think, he waited for hours in an emergency room before being correctly diagnosed and rushed into surgery. Over the next few days, as he clung to life and the first light of a new year came through his window, he found himself reflecting on the fragility of health, not recognized in America as a human right but without which all rights and freedoms have no meaning.And that was before the pandemic. We have since watched American hospitals, long understaffed and undersupplied, buckling under waves of coronavirus patients. The federal government made matters worse through willful ignorance, misinformation, and profiteering. Our system of commercial medicine failed the ultimate test, and thousands of Americans died.In this eye-opening cri de coeur, Snyder traces the societal forces that led us here and outlines the lessons we must learn to survive. In examining some of the darkest moments of recent history and of his own life, Snyder finds glimmers of hope and principles that could lead us out of our current malaise. Only by enshrining healthcare as a human right, elevating the authority of doctors and medical knowledge, and planning for our children's future can we create an America where everyone is truly free.

Dopesick: Dealers, Doctors, and the Drug Company that Addicted America


Beth Macy - 2018
    From distressed small communities in Central Appalachia to wealthy suburbs; from disparate cities to once-idyllic farm towns; it's a heartbreaking trajectory that illustrates how this national crisis has persisted for so long and become so firmly entrenched. Beginning with a single dealer who lands in a small Virginia town and sets about turning high school football stars into heroin overdose statistics, Macy endeavors to answer a grieving mother's question-why her only son died-and comes away with a harrowing story of greed and need. From the introduction of OxyContin in 1996, Macy parses how America embraced a medical culture where overtreatment with painkillers became the norm. In some of the same distressed communities featured in her bestselling book Factory Man, the unemployed use painkillers both to numb the pain of joblessness and pay their bills, while privileged teens trade pills in cul-de-sacs, and even high school standouts fall prey to prostitution, jail, and death.Through unsparing, yet deeply human portraits of the families and first responders struggling to ameliorate this epidemic, each facet of the crisis comes into focus. In these politically fragmented times, Beth Macy shows, astonishingly, that the only thing that unites Americans across geographic and class lines is opioid drug abuse. But in a country unable to provide basic healthcare for all, Macy still finds reason to hope-and signs of the spirit and tenacity necessary in those facing addiction to build a better future for themselves and their families.

Amity and Prosperity: One Family and the Fracturing of America


Eliza Griswold - 2018
    This is an incredible true account of investigative journalism and a devastating indictment of energy politics in America.Stacey Haney, a lifelong resident of Amity, Pennsylvania, is struggling to support her children when the fracking boom comes to town. Like most of her neighbors, she sees the energy companies' payments as a windfall. Soon trucks are rumbling down her unpaved road and a fenced-off fracking site rises on adjacent land. But her annoyance gives way to concern and then to fear as domestic animals and pets begin dying and mysterious illnesses strike her family--despite the companies' insistence that nothing is wrong.Griswold masterfully chronicles Haney's transformation into an unlikely whistle-blower as she launches her own investigation into corporate wrongdoing. As she takes her case to court, Haney inadvertently reveals the complex rifts in her community and begins to reshape its attitudes toward outsiders, corporations, and the federal government. Amity and Prosperity uses her gripping and moving tale to show the true costs of our energy infrastructure and to illuminate the predicament of rural America in the twenty-first century.

The Revolt of the Public and the Crisis of Authority


Martin Gurri - 2014
    In the words of economist and scholar Arnold Kling, Martin Gurri saw it coming.Technology has categorically reversed the information balance of power between the public and the elites who manage the great hierarchical institutions of the industrial age government, political parties, the media.The Revolt of the Public tells the story of how insurgencies, enabled by digital devices and a vast information sphere, have mobilized millions of ordinary people around the world.Originally published in 2014, this updated edition of The Revolt of the Public includes an extensive analysis of Donald Trump's improbable rise to the presidency and the electoral triumphs of Brexit and concludes with a speculative look forward, pondering whether the current elite class can bring about a reformation of the democratic process and whether new organizing principles, adapted to a digital world, can arise out of the present political turbulence.

The Spirit Level: Why More Equal Societies Almost Always Do Better


Richard G. Wilkinson - 2009
    Why do we mistrust people more in the UK than in Japan? Why do Americans have higher rates of teenage pregnancy than the French? What makes the Swedish thinner than the Greeks? The answer: inequality. This groundbreaking book, based on years of research, provides hard evidence to show how almost everything—-from life expectancy to depression levels, violence to illiteracy-—is affected not by how wealthy a society is, but how equal it is. Urgent, provocative and genuinely uplifting, The Spirit Level has been heralded as providing a new way of thinking about ourselves and our communities, and could change the way you see the world.

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

Critical: What We Can Do About the Health-Care Crisis


Tom Daschle - 2008
     Undoubtedly, the biggest domestic policy issue in the coming years will be America’s health-care system. Millions of Americans go without medical care because they can’t afford it, and many others are mired in debt because they can’t pay their medical bills. It’s hard to think of another public policy problem that has lingered unaddressed for so long. Why have we failed to solve a problem that is such a high priority for so many citizens? Former Senate Majority Leader Tom Daschle believes the problem is rooted in the complexity of the health-care issue and the power of the interest groups—doctors, hospitals, insurers, drug companies, researchers, patient advocates—that have a direct stake in it. Rather than simply pointing out the major flaws and placing blame, Daschle offers key solutions and creates a blueprint for solving the crisis. Daschle’s solution lies in the Federal Reserve Board, which has overseen the equally complicated financial system with great success. A Fed-like health board would offer a public framework within which a private health-care system can operate more effectively and efficiently—insulated from political pressure yet accountable to elected officials and the American people. Daschle argues that this independent board would create a single standard of care and exert tremendous influence on every other provider and payer, even those in the private sector. After decades of failed incremental measures, the American health-care system remains fundamentally broken and requires a comprehensive fix. With his bold and forward-looking plan, Daschle points us to the solution.

County: Life, Death and Politics at Chicago's Public Hospital


David A. Ansell - 2011
    From its inception as a "Poor House" dispensing free medical care to indigents, Chicago's Cook County Hospital has been both a renowned teaching hospital and the healthcare provider of last resort for the city's uninsured. COUNTY covers more than thirty years of its history, beginning in the late 1970s when the author began his internship, to the "Final Rounds" when the enormous iconic Victorian hospital building was replaced and hundreds of former trainees gathered to bid it an emotional farewell.Ansell writes of the hundreds of doctors who went through the rigorous training process with him, sharing his vision of saving the world and of resurrecting a hospital on the verge of closing. Radical Medicine is about people, from Ansell’s mentors, including the legendary Quentin Young, to the multitude of patients whom he and County’s medical staff labored to diagnose and heal. It is a story about politics, from contentious union strikes to battles against “patient dumping”, and public health, depicting the AIDS crisis and the opening of County’s HIV/AIDS clinic, the first in the city.Finally, it is about a young man’s medical education in urban America, a coming-of-age story set against a backdrop of race, segregation and poverty.

Being Mortal: Medicine and What Matters in the End


Atul Gawande - 2014
    But in the inevitable condition of aging and death, the goals of medicine seem too frequently to run counter to the interest of the human spirit. Nursing homes, preoccupied with safety, pin patients into railed beds and wheelchairs. Hospitals isolate the dying, checking for vital signs long after the goals of cure have become moot. Doctors, committed to extending life, continue to carry out devastating procedures that in the end extend suffering.Gawande, a practicing surgeon, addresses his profession's ultimate limitation, arguing that quality of life is the desired goal for patients and families. Gawande offers examples of freer, more socially fulfilling models for assisting the infirm and dependent elderly, and he explores the varieties of hospice care to demonstrate that a person's last weeks or months may be rich and dignified.