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.

History of Medicine: A Scandalously Short Introduction


Jacalyn Duffin - 1999
    Organized conceptually around the major fields of medical endeavour - anatomy, physiology, pathology, pharmacology, surgery, obstetrics, psychiatry, pediatrics, and family medicine - this book is an accessible overview of medical history as a vibrant component of social, intellectual, and cultural history, and as a research discipline in its own right.Each chapter begins in antiquity and ends in the twentieth century. Throughout, Duffin shows that alternative interpretations can be found for most elements of our past and that topics of interest can go well beyond 'great men' and 'great discoveries' to include ideas, diseases, patients, institutions, and great mistakes. This approach does not mean that the 'great men' (and women) are neglected; rather they appear in context. Medical disasters such as chloramphenicol and thalidomide, are covered along with the triumphs, and examples from Canada's past, largely ignored in other medical histories, are included. A chapter on methodology, suggestions for further reading with special attention to Canadian sources, and a careful index make it possible to research a specific event or historical debate, or to satisfy a more general curiosity.By presenting the material in a structure that resonates with the broad outlines of medical training, and by focusing on the questions asked most often, this text is a relevant guide for students to the history of the profession they are about to embrace, and for those who would teach them, be they physicians or historians. Duffin's clear and entertaining prose and the many illustrations will help to demystify medicine for general readers and for students in other domains, such as history, philosophy, and sociology.

The End of Medicine: How Silicon Valley (and Naked Mice) Will Reboot Your Doctor


Andy Kessler - 2006
    Too bad. Because medicine isn't an industry, it's practically witchcraft. Despite the growth of big pharma, HMOs, and hospital chains, medicine remains the isolated work of individual doctors—and the system is going broke fast.So why is Andy Kessler—the man who told you outrageous stories of Wall Street analysts gone bad in Wall Street Meat and tales from inside a hedge fund in Running Money—poking around medicine for the next big wave of technology?It's because he smells change coming. Heart attacks, strokes, and cancer are a huge chunk of medical spending, yet there's surprisingly little effort to detect disease before it's life threatening. How lame is that—especially since the technology exists today to create computer-generated maps of your heart and colon?Because it's too expensive—for now. But Silicon Valley has turned computing, telecom, finance, music, and media upside down by taking expensive new technologies and making them ridiculously cheap. So why not the $1.8 trillion health care business, where the easiest way to save money is to stop folks from getting sick in the first place?Join Kessler's bizarre search for the next big breakthrough as he tries to keep from passing out while following cardiologists around, cracks jokes while reading mammograms, and watches twitching mice get injected with radioactive probes. Looking for a breakthrough, Kessler even selflessly pokes, scans, and prods himself.CT scans of your heart will identify problems before you have a heart attack or stroke; a nanochip will search your blood for cancer cells--five years before they grow uncontrollably and kill you; and baby boomers can breathe a little easier because it's all starting to happen now.Your doctor can't be certain what's going on inside your body, but technology will. Embedding the knowledge of doctors in silicon will bring a breakout technology to health care, and we will soon see an end of medicine as we know it.

Opening My Heart: A Journey from Nurse to Patient and Back Again


Tilda Shalof - 2011
    That is, until she could no longer ignore her extreme fatigue, shortness of breath, and crushing chest pains. When the results came in, it was time to face the music: Tilda required immediate open-heart surgery to replace a defective valve and to repair damage done to this vital organ.  Tilda’s story takes readers from the diagnosis through all her fears and concerns, the or, her stay in the icu, the cardiac ward, recovery at home, rehabilitation, and ultimately, her return to work in the hospital armed with new insights on the patient’s perspective. She learned more in her week-long stay as a patient than in all her years caring for the critically ill, especially about trust and working in partnership with her caregivers. In Opening My Heart, Shalof expertly weaves recollections from her career and accounts of other nurses’ experiences into her own story, creating the perfect marriage between fascinating clinical detail and a personal journey of healing. Throughout it all is Shalof’s warm, friendly voice and humorous outlook. Nurses everywhere and anyone who’s ever been a hospital patient, or who is currently hospitalized or who might be one day (and those who love them!), will be empowered, enlightened, comforted, and entertained by this book.

Service Fanatics: How to Build Superior Patient Experience the Cleveland Clinic Way


James Merlino - 2014
    There was atime when this revered organization ranked among the lowest in the country in this area. Within ten years, however, it had climbed to among the highest and has emerged as the thought leader in the space.How did Cleveland Clinic turn itself around so effectively and so quickly?More important, how can you do the same with your organization?In gripping, visceral, on-the ground fashion, Service Fanatics reveals the strategies and tactics the Clinic applied to become one of today's leading patient-experience healthcare organizations--methods that seamlessly translate to any business seeking to improveits customer experience. This strategic guide covers:How the Clinic's leaders redefined the concept of patient experience and developed a strategy to improve itCritical lessons learned regarding organization, recruitment, training, and measuring service excellenceWays in which the Clinic aligned its entire workforce around its Patients First strategyHow leaders improved the critical element of physician communicationRather than view patients simply as sick people who need treatment, Cleveland Clinic sees them also as important stakeholders in the organization's success. Patients are customers--who desire, pay for, and deserve the best possible care and experience during what is often a challenging time in their lives.Featuring customer service case studies, as well as invaluable insight from C-level executives at top corporations in various industries, Service Fanatics provides actionable lessons for any manager and business leader beyond healthcare.Whether you run a healthcare institution, nonprofit, or for-profit business, Service Fanatics will help you create the kind of customer experience that promises to transform your organization into an industry powerhouse.

A Map of the Child: A Pediatrician's Tour of the Body


Darshak Sanghavi - 2003
    . . Sanghavi is a vivid and effortless teller of human tales and quite evidently a special doctor, too." —Atul Gawande, author of ComplicationsIn this compelling book, Dr. Darshak Sanghavi takes the reader on a dramatic tour of a child's eight vital organs, beginning with the lungs and proceeding through the heart, blood, bones, brain, skin, gonads, and gut.Along the way, we meet children and families in extraordinary circumstances—a premature baby named Adam Flax who was born with undeveloped lungs, a teenage boy with a positive pregnancy test, and a young girl who keeps losing weight despite her voracious appetite. In a deeply personal narrative, Sanghavi provides a richly detailed—and humanized—portrait of how the pediatric body functions in both sickness and health.

Teeth: Beauty, Inequality, and the Struggle for Oral Health in America


Mary Otto - 2017
    Otto’s subjects include the pioneering dentist who made Shirley Temple and Judy Garland’s teeth sparkle on the silver screen and helped create the all-American image of “pearly whites”; Deamonte Driver, the young Maryland boy whose tragic death from an abscessed tooth sparked congressional hearings; and a marketing guru who offers advice to dentists on how to push new and expensive treatments and how to keep Medicaid patients at bay.In one of its most disturbing findings, Teeth reveals that toothaches are not an occasional inconvenience, but rather a chronic reality for millions of people, including disproportionate numbers of the elderly and people of color. Many people, Otto reveals, resort to prayer to counteract the uniquely devastating effects of dental pain.Otto also goes back in time to understand the roots of our predicament in the history of dentistry, showing how it became separated from mainstream medicine, despite a century of growing evidence that oral health and general bodily health are closely related.Muckraking and paradigm-shifting, Teeth exposes for the first time the extent and meaning of our oral health crisis. It joins the small shelf of books that change the way we view society and ourselves—and will spark an urgent conversation about why our teeth matter.This is an alternate cover edition of ISBN 9781620971444.

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.

Bottle of Lies: The Inside Story of the Generic Drug Boom


Katherine Eban - 2019
    Drawing on exclusive accounts from whistleblowers and regulators, as well as thousands of pages of confidential FDA documents, Eban reveals an industry where fraud is rampant, companies routinely falsify data, and executives circumvent almost every principle of safe manufacturing to minimize cost and maximize profit, confident in their ability to fool inspectors. Meanwhile, patients unwittingly consume medicine with unpredictable and dangerous effects.The story of generic drugs is truly global. It connects middle America to China, India, sub-Saharan Africa and Brazil, and represents the ultimate litmus test of globalization: what are the risks of moving drug manufacturing offshore, and are they worth the savings? A decade-long investigation with international sweep, high-stakes brinkmanship and big money at its core, Bottle of Lies reveals how the world’s greatest public-health innovation has become one of its most astonishing swindles.

The Truth about the Drug Companies: How They Deceive Us and What to Do about It


Marcia Angell - 2004
    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.

Epic Measures: One Doctor. Seven Billion Patients.


Jeremy N. Smith - 2015
    While it is one of the largest scientific projects ever attempted—as breathtaking as the first moon landing or the Human Genome Project—the questions it answers are meaningful for every one of us: What are the world’s health problems? Who do they hurt? How much? Where? Why?Murray argues that the ideal existence isn’t simply the longest but the one lived well and with the least illness. Until we can accurately measure how people live and die, we cannot understand what makes us sick or do much to improve it. Challenging the accepted wisdom of the WHO and the UN, the charismatic and controversial health maverick has made enemies—and some influential friends, including Bill Gates who gave Murray a $100 million grant.In Epic Measures, journalist Jeremy N. Smith offers an intimate look at Murray and his groundbreaking work. From ranking countries’ healthcare systems (the U.S. is 37th) to unearthing the shocking reality that world governments are funding developing countries at only 30% of the potential maximum efficiency when it comes to health, Epic Measures introduces a visionary leader whose unwavering determination to improve global health standards has already changed the way the world addresses issues of health and wellness, sets policy, and distributes funding.

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America


Robert Whitaker - 2010
    What is going on? Anatomy of an Epidemic challenges readers to think through that question themselves. First, Whitaker investigates what is known today about the biological causes of mental disorders. Do psychiatric medications fix “chemical imbalances” in the brain, or do they, in fact, create them? Researchers spent decades studying that question, and by the late 1980s, they had their answer. Readers will be startled—and dismayed—to discover what was reported in the scientific journals. Then comes the scientific query at the heart of this book: During the past fifty years, when investigators looked at how psychiatric drugs affected long-term outcomes, what did they find? Did they discover that the drugs help people stay well? Function better? Enjoy good physical health? Or did they find that these medications, for some paradoxical reason, increase the likelihood that people will become chronically ill, less able to function well, more prone to physical illness?  This is the first book to look at the merits of psychiatric medications through the prism of long-term results. Are long-term recovery rates higher for medicated or unmedicated schizophrenia patients? Does taking an antidepressant decrease or increase the risk that a depressed person will become disabled by the disorder? Do bipolar patients fare better today than they did forty years ago, or much worse? When the National Institute of Mental Health (NIMH) studied the long-term outcomes of children with ADHD, did they determine that stimulants provide any benefit?  By the end of this review of the outcomes literature, readers are certain to have a haunting question of their own: Why have the results from these long-term studies—all of which point to the same startling conclusion—been kept from the public?  In this compelling history, Whitaker also tells the personal stories of children and adults swept up in this epidemic. Finally, he reports on innovative programs of psychiatric care in Europe and the United States that are producing good long-term outcomes. Our nation has been hit by an epidemic of disabling mental illness, and yet, as Anatomy of an Epidemic reveals, the medical blueprints for curbing that epidemic have already been drawn up.

Before Ebola: Dispatches from a Deadly Outbreak (Kindle Single)


Peter Apps - 2014
    The year is 2005. A highly infectious, unidentified Ebola-like virus is sweeping through the slums and villages of northern Angola. Within months, more than 200 people have died, medical services have collapsed and aid workers are on the brink of exhaustion. At 23, Peter Apps was just starting out as a foreign correspondent when Reuters sent him into the heart of the outbreak to get the story. In “Before Ebola: Dispatches from a Deadly Outbreak” Apps recalls in vivid, unflinching detail the horrors of life in a hot zone, the compassion of those trying to contain it, and how a terrified young journalist came of age in a time of almost unbearable crisis. Peter Apps is a global defense correspondent for Reuters news, currently dividing his time between London and Washington, D.C. In September 2006, Apps broke his neck in a minibus crash while covering the Sri Lankan civil war, leaving him largely paralyzed from the shoulders down. Cover design by Kristen Radtke.

Uncontrolled Spread: Why Covid-19 Crushed Us and How We Can Defeat the Next Pandemic


Scott Gottlieb
    --Wall Street Journal"Informative and well paced."--The Guardian"An intense ride through the pandemic with chilling details of what really happened. It is also sprinkled with notes of true wisdom that may help all of us better prepare for the future."--Sanjay Gupta, MD, chief medical correspondent, CNNPhysician and former FDA commissioner Scott Gottlieb asks: Has America's COVID-19 catastrophe taught us anything?In Uncontrolled Spread, he shows how the coronavirus and its variants were able to trounce America's pandemic preparations, and he outlines the steps that must be taken to protect against the next outbreak. As the pandemic unfolded, Gottlieb was in regular contact with all the key players in Congress, the Trump administration, and the drug and diagnostic industries. He provides an inside account of how level after level of American government crumbled as the COVID-19 crisis advanced.A system-wide failure across government institutions left the nation blind to the threat, and unable to mount an effective response. We'd prepared for the wrong virus. We failed to identify the contagion early enough and became overly reliant on costly and sometimes divisive tactics that couldn't fully slow the spread. We never considered asymptomatic transmission and we assumed people would follow public health guidance. Key bureaucracies like the CDC were hidebound and outmatched. Weak political leadership aggravated these woes. We didn't view a public health disaster as a threat to our national security.Many of the woes sprung from the CDC, which has very little real-time reporting capability to inform us of Covid's twists and turns or assess our defenses. The agency lacked an operational capacity and mindset to mobilize the kind of national response that was needed. To guard against future pandemic risks, we must remake the CDC and properly equip it to better confront crises. We must also get our intelligence services more engaged in the global public health mission, to gather information and uncover emerging risks before they hit our shores so we can head them off. For this role, our clandestine agencies have tools and capabilities that the CDC lacks.Uncontrolled Spread argues we must fix our systems and prepare for a deadlier coronavirus variant, a flu pandemic, or whatever else nature -- or those wishing us harm -- may threaten us with. Gottlieb outlines policies and investments that are essential to prepare the United States and the world for future threats.

Faucian Booster: Covid Vaccine Mandates Violate the Nuremberg Code and Therefore Should Be Opposed and Resisted by Any Peaceable Means Necessary


Steve Deace - 2021