But as costs levitate, that argument becomes more difficult to make. Today, we spend twice as much as Japan on health care—yet few would argue that our health care system is twice as good.Instead, startling new evidence suggests that one out of every three of our health care dollars is squandered on unnecessary or redundant tests; unproven, sometimes unwanted procedures; and overpriced drugs and devices that, too often, are no better than the less expensive products they have replaced.How did this happen? In Money-Driven Medicine, Maggie Mahar takes the reader behind the scenes of a $2 trillion industry to witness how billions of dollars are wasted in a Hobbesian marketplace that pits the industry's players against each other. In remarkably candid interviews, doctors, hospital administrators, patients, health care economists, corporate executives, and Wall Street analysts describe a war of "all against all" that can turn physicians, hospitals, insurers, drugmakers, and device makers into blood rivals. Rather than collaborating, doctors and hospitals compete. Rather than sharing knowledge, drugmakers and device makers divide value. Rather than thinking about long-term collective goals, the imperatives of an impatient marketplace force health care providers to focus on short-term fiscal imperatives. And so investments in untested bleeding-edge medical technologies crowd out investments in information technology that might, in the long run, not only reduce errors but contain costs.In theory, free market competition should tame health care inflation. In fact, Mahar demonstrates, when it comes to medicine, the traditional laws of supply and demand do not apply. Normally, when supply expands, prices fall. But in the health care industry, as the number and variety of drugs, devices, and treatments multiplies, demand rises to absorb the excess, and prices climb. Meanwhile, the perverse incentives of a fee-for-service system reward health care providers for doing more, not less.In this superbly written book, Mahar shows why doctors must take responsibility for the future of our health care industry. Today, she observes, "physicians have been stripped of their standing as professionals: Insurers address them as vendors ('Dear Health Care Provider'), drugmakers and device makers see them as customers (someone you might take to lunch or a strip club), while . . . consumers (aka patients) are encouraged to see their doctors as overpaid retailers. . . . Before patients can reclaim their rightful place as the center—and indeed as the raison d'être—of our health care system," Mahar suggests, "we must once again empower doctors . . . to practice patient-centered medicine—based not on corporate imperatives, doctors' druthers, or even patients' demands," but on the best scientific research available.

    This new edition includes an all-embracing and incisive afterword that examines the current state of health care and our relationship with life as it approaches its terminus. It also discusses how we can take control of our own final days and those of our loved ones.Shewin Nuland's masterful How We Die is even more relevant than when it was first published.

    But as Jane Mayer shows in this powerful, meticulously reported history, a network of exceedingly wealthy people with extreme libertarian views bankrolled a systematic, step-by-step plan to fundamentally alter the American political system.The network has brought together some of the richest people on the planet. Their core beliefs—that taxes are a form of tyranny; that government oversight of business is an assault on freedom—are sincerely held. But these beliefs also advance their personal and corporate interests: Many of their companies have run afoul of federal pollution, worker safety, securities, and tax laws.The chief figures in the network are Charles and David Koch, whose father made his fortune in part by building oil refineries in Stalin’s Russia and Hitler’s Germany. The patriarch later was a founding member of the John Birch Society, whose politics were so radical it believed Dwight Eisenhower was a communist. The brothers were schooled in a political philosophy that asserted the only role of government is to provide security and to enforce property rights.When libertarian ideas proved decidedly unpopular with voters, the Koch brothers and their allies chose another path. If they pooled their vast resources, they could fund an interlocking array of organizations that could work in tandem to influence and ultimately control academic institutions, think tanks, the courts, statehouses, Congress, and, they hoped, the presidency. Richard Mellon Scaife, the mercurial heir to banking and oil fortunes, had the brilliant insight that most of their political activities could be written off as tax-deductible “philanthropy.”These organizations were given innocuous names such as Americans for Prosperity. Funding sources were hidden whenever possible. This process reached its apotheosis with the allegedly populist Tea Party movement, abetted mightily by the Citizens United decision—a case conceived of by legal advocates funded by the network.The political operatives the network employs are disciplined, smart, and at times ruthless. Mayer documents instances in which people affiliated with these groups hired private detectives to impugn whistle-blowers, journalists, and even government investigators. And their efforts have been remarkably successful. Libertarian views on taxes and regulation, once far outside the mainstream and still rejected by most Americans, are ascendant in the majority of state governments, the Supreme Court, and Congress. Meaningful environmental, labor, finance, and tax reforms have been stymied.Jane Mayer spent five years conducting hundreds of interviews-including with several sources within the network-and scoured public records, private papers, and court proceedings in reporting this book. In a taut and utterly convincing narrative, she traces the byzantine trail of the billions of dollars spent by the network and provides vivid portraits of the colorful figures behind the new American oligarchy.Dark Money is a book that must be read by anyone who cares about the future of American democracy.

    Jonathan Eig's masterful narrative revolves around four principal characters: the fiery feminist Margaret Sanger, who was a champion of birth control in her campaign for the rights of women but neglected her own children in pursuit of free love; the beautiful Katharine McCormick, who owed her fortune to her wealthy husband, the son of the founder of International Harvester and a schizophrenic; the visionary scientist Gregory Pincus, who was dismissed by Harvard in the 1930s as a result of his experimentation with in vitro fertilization but who, after he was approached by Sanger and McCormick, grew obsessed with the idea of inventing a drug that could stop ovulation; and the telegenic John Rock, a Catholic doctor from Boston who battled his own church to become an enormously effective advocate in the effort to win public approval for the drug that would be marketed by Searle as Enovid.Spanning the years from Sanger’s heady Greenwich Village days in the early twentieth century to trial tests in Puerto Rico in the 1950s to the cusp of the sexual revolution in the 1960s, this is a grand story of radical feminist politics, scientific ingenuity, establishment opposition, and, ultimately, a sea change in social attitudes. Brilliantly researched and briskly written, The Birth of the Pill is gripping social, cultural, and scientific history.

    Theodore Dalrymple, a British psychiatrist who treats the poor in a slum hospital and a prison in England, has seemingly seen it all. Yet in listening to and observing his patients, he is continually astonished by the latest twist of depravity that exceeds even his own considerable experience. Dalrymple's key insight in Life at the Bottom is that long-term poverty is caused not by economics but by a dysfunctional set of values, one that is continually reinforced by an elite culture searching for victims. This culture persuades those at the bottom that they have no responsibility for their actions and are not the molders of their own lives. Drawn from the pages of the cutting-edge political and cultural quarterly City Journal, Dalrymple's book draws upon scores of eye-opening, true-life vignettes that are by turns hilariously funny, chillingly horrifying, and all too revealing-sometimes all at once. And Dalrymple writes in prose that transcends journalism and achieves the quality of literature.

    But it was only when his own son-in the throes of a manic episode-broke into a neighbor's house that he learned what happens to mentally ill people who break a law. This is the Earley family's compelling story, a troubling look at bureaucratic apathy and the countless thousands who suffer confinement instead of care, brutal conditions instead of treatment, in the "revolving doors" between hospital and jail. With mass deinstitutionalization, large numbers of state mental patients are homeless or in jail-an experience little better than the horrors of a century ago. Earley takes us directly into that experience-and into that of a father and award-winning journalist trying to fight for a better way.

    The age-old disease spread swiftly through an increasingly interconnected American landscape: from southern tobacco plantations to the dense immigrant neighborhoods of northern cities to far-flung villages on the edges of the nascent American empire. In Pox, award-winning historian Michael Willrich offers a gripping chronicle of how the nation's continentwide fight against smallpox launched one of the most important civil liberties struggles of the twentieth century.At the dawn of the activist Progressive era and during a moment of great optimism about modern medicine, the government responded to the deadly epidemic by calling for universal compulsory vaccination. To enforce the law, public health authorities relied on quarantines, pesthouses, and "virus squads"-corps of doctors and club-wielding police. Though these measures eventually contained the disease, they also sparked a wave of popular resistance among Americans who perceived them as a threat to their health and to their rights.At the time, anti-vaccinationists were often dismissed as misguided cranks, but Willrich argues that they belonged to a wider legacy of American dissent that attended the rise of an increasingly powerful government. While a well-organized anti-vaccination movement sprang up during these years, many Americans resisted in subtler ways-by concealing sick family members or forging immunization certificates. Pox introduces us to memorable characters on both sides of the debate, from Henning Jacobson, a Swedish Lutheran minister whose battle against vaccination went all the way to the Supreme Court, to C. P. Wertenbaker, a federal surgeon who saw himself as a medical missionary combating a deadly-and preventable-disease.As Willrich suggests, many of the questions first raised by the Progressive-era antivaccination movement are still with us: How far should the government go to protect us from peril? What happens when the interests of public health collide with religious beliefs and personal conscience? In Pox, Willrich delivers a riveting tale about the clash of modern medicine, civil liberties, and government power at the turn of the last century that resonates powerfully today.

    Sharon Moalem turns our current understanding of illness on its head and challenges us to fundamentally change the way we think about our bodies, our health, and our relationship to just about every other living thing on earth, from plants and animals to insects and bacteria.Through a fresh and engaging examination of our evolutionary history, Dr. Moalem reveals how many of the conditions that are diseases today actually gave our ancestors a leg up in the survival sweepstakes. When the option is a long life with a disease or a short one without it, evolution opts for disease almost every time.Everything from the climate our ancestors lived in to the crops they planted and ate to their beverage of choice can be seen in our genetic inheritance. But Survival of the Sickest doesn't stop there. It goes on to demonstrate just how little modern medicine really understands about human health, and offers a new way of thinking that can help all of us live longer, healthier lives..

    One - now the minority - functions in a print-based, literate world that can cope with complexity and can separate illusion from truth. The other - the majority - is retreating from a reality-based world into one of false certainty and magic. To this majority - which crosses social class lines, though the poor are overwhelmingly affected - presidential debate and political rhetoric is pitched at a sixth-grade reading level. In this “other America,” serious film and theater, as well as newspapers and books, are being pushed to the margins of society. In the tradition of Christopher Lasch’s The Culture of Narcissism and Neil Postman’s Amusing Ourselves to Death, Pulitzer Prize-winner Chris Hedges navigates this culture - attending WWF contests, the Adult Video News Awards in Las Vegas, and Ivy League graduation ceremonies - to expose an age of terrifying decline and heightened self-delusion.

    Now the director of the Heart Failure Program at a Long Island hospital, Jauhar uses his own story as a scalpel to lay open the American health-care system.The patient is ill indeed. A perverse system forces doctors to prescribe unnecessary tests and participate in an elaborate system of cronyism just to cover costs and protect themselves from malpractice suits. Jauhar reports cases where a single patient might see fifteen specialists in one hospital stay, fail to receive a full picture of his actual condition, and leave with a bill for hundreds of thousands of dollars. Jauhar himself wrestles with his conscience as, struggling to make ends meet, he moonlights for a practitioner who charges exorbitant fees for tests of questionable value.Doctored is a cry for reform; a fascinating look at what really goes on in examining rooms, ORs, and your own doctor’s mind; and, most of all, a deeply personal and unsparing act of introspection by a physician who wants to return meaning and moral grounding to a noble profession that has lost its way. It is certain to kick off controversy and heated debate at a time when the dysfunctionalities of our health-care system remain at the top of the nation’s agenda.

    Debbie Preece’s fight for accountability for her brother’s death took her well beyond the Sav-Rite Pharmacy in coal country, ultimately leading to three of the biggest drug wholesalers in the country. She was joined by a crusading lawyer and by local journalist, Eric Eyre, who uncovered a massive opioid pill-dumping scandal that shook the foundation of America’s largest drug companies—and won him a Pulitzer Prize. Death in Mud Lick details the clandestine meetings with whistleblowers; a court fight to unseal filings that the drug distributors tried to keep hidden, a push to secure the DEA pill-shipment data, and the fallout after Eyre’s local paper, the Gazette-Mail, the smallest newspaper ever to win a Pulitzer Prize for investigative reporting, broke the story.

    Inspired by his own experiences working as an infectious diseases physician in Africa, Jacques Pepin looks back to the early twentieth-century events in Africa that triggered the emergence of HIV/AIDS and traces its subsequent development into the most dramatic and destructive epidemic of modern times. He shows how the disease was first transmitted from chimpanzees to man and then how urbanization, prostitution, and large-scale colonial medical campaigns intended to eradicate tropical diseases combined to disastrous effect to fuel the spread of the virus from its origins in Leopoldville to the rest of Africa, the Caribbean and ultimately worldwide. This is an essential new perspective on HIV/AIDS and on the lessons that must be learnt if we are to avoid provoking another pandemic in the future.

    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.

    Through a series of disastrous decisions, the state government had switched the city’s water to a source that corroded Flint’s aging lead pipes. Complaints about the foul-smelling water were dismissed: the residents of Flint—a largely poor African American city of about 100,000 people—were not seen as credible, even in matters of their own lives.It took 18 months of activism and a band of dogged outsiders to force the state to admit that the water was poisonous. But this was only after 12 people died and Flint's children suffered irreparable harm. The long battle for accountability and a humane response to this man-made disaster have only just begun.In the first full-length account of this epic failure, The Poisoned City recounts the gripping story of Flint’s poisoned water through the people who caused it, suffered from it, and exposed it. It is a chronicle of one town, but could also be about any American city, all made precarious by the neglect of infrastructure and the erosion of democratic decision-making. Cities like Flint are set up to fail—and for the people who live and work in them, the consequences may be mortal.A 2019 Library of Michigan Notable Books

    Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become–and argues for essential, long-overdue change.Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.