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 Gift: The Form and Reason for Exchange in Archaic Societies


Marcel Mauss - 1923
    The gift is a perfect example of what Mauss calls a total social phenomenon, since it involves legal, economic, moral, religious, aesthetic, and other dimensions. He sees the gift exchange as related to individuals and groups as much as to the objects themselves, and his analysis calls into question the social conventions and economic systems that had been taken for granted for so many years. In a modern translation, introduced by distinguished anthropologist Mary Douglas, The Gift is essential reading for students of social anthropology and sociology.

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.

Fast Food Nation: The Dark Side of the All-American Meal


Eric Schlosser - 2001
    That's a lengthy list of charges, but here Eric Schlosser makes them stick with an artful mix of first-rate reportage, wry wit, and careful reasoning.Schlosser's myth-shattering survey stretches from California's subdivisions where the business was born to the industrial corridor along the New Jersey Turnpike where many fast food's flavors are concocted. Along the way, he unearths a trove of fascinating, unsettling truths -- from the unholy alliance between fast food and Hollywood to the seismic changes the industry has wrought in food production, popular culture, and even real estate. (back cover)

Bad Blood: The Tuskegee Syphilis Experiment


James H. Jones - 1981
    The Tuskegee Study had nothing to do with treatment. Its purpose was to trace the spontaneous evolution of the disease in order to learn how syphilis affected black subjects.The men were not told they had syphilis; they were not warned about what the disease might do to them; and, with the exception of a smattering of medication during the first few months, they were not given health care. Instead of the powerful drugs they required, they were given aspirin for their aches and pains. Health officials systematically deceived the men into believing they were patients in a government study of “bad blood”, a catch-all phrase black sharecroppers used to describe a host of illnesses. At the end of this 40 year deathwatch, more than 100 men had died from syphilis or related complications.“Bad Blood” provides compelling answers to the question of how such a tragedy could have been allowed to occur. Tracing the evolution of medical ethics and the nature of decision making in bureaucracies, Jones attempted to show that the Tuskegee Study was not, in fact, an aberration, but a logical outgrowth of race relations and medical practice in the United States.Now, in this revised edition of “Bad Blood”, Jones traces the tragic consequences of the Tuskegee Study over the last decade. A new introduction explains why the Tuskegee Study has become a symbol of black oppression and a metaphor for medical neglect, inspiring a prize-winning play, a Nova special, and a motion picture. A new concluding chapter shows how the black community's wide-spread anger and distrust caused by the Tuskegee Study has hampered efforts by health officials to combat AIDS in the black community. “Bad Blood” was nominated for the Pulitzer Prize and was one of the “N.Y. Times” 12 best books of the year.

The Body Multiple: Ontology in Medical Practice


Annemarie Mol - 2002
    Drawing on fieldwork in a Dutch university hospital, Annemarie Mol looks at the day-to-day diagnosis and treatment of atherosclerosis. A patient information leaflet might describe atherosclerosis as the gradual obstruction of the arteries, but in hospital practice this one medical condition appears to be many other things. From one moment, place, apparatus, specialty, or treatment, to the next, a slightly different “atherosclerosis” is being discussed, measured, observed, or stripped away. This multiplicity does not imply fragmentation; instead, the disease is made to cohere through a range of tactics including transporting forms and files, making images, holding case conferences, and conducting doctor-patient conversations.The Body Multiple juxtaposes two distinct texts. Alongside Mol’s analysis of her ethnographic material—interviews with doctors and patients and observations of medical examinations, consultations, and operations—runs a parallel text in which she reflects on the relevant literature. Mol draws on medical anthropology, sociology, feminist theory, philosophy, and science and technology studies to reframe such issues as the disease-illness distinction, subject-object relations, boundaries, difference, situatedness, and ontology. In dialogue with one another, Mol’s two texts meditate on the multiplicity of reality-in-practice.Presenting philosophical reflections on the body and medical practice through vivid storytelling, The Body Multiple will be important to those in medical anthropology, philosophy, and the social study of science, technology, and medicine.

In Pain: A Bioethicist's Personal Struggle with Opioids


Travis Rieder - 2019
    Enduring half a dozen surgeries, the drugs he received were both miraculous and essential to his recovery. But his most profound suffering came several months later when he went into acute opioid withdrawal while following his physician’s orders. Over the course of four excruciating weeks, Rieder learned what it means to be “dope sick”—the physical and mental agony caused by opioid dependence. Clueless how to manage his opioid taper, Travis’s doctors suggested he go back on the drugs and try again later. Yet returning to pills out of fear of withdrawal is one route to full-blown addiction. Instead, Rieder continued the painful process of weaning himself.Rieder’s experience exposes a dark secret of American pain management: a healthcare system so conflicted about opioids, and so inept at managing them, that the crisis currently facing us is both unsurprising and inevitable. As he recounts his story, Rieder provides a fascinating look at the history of these drugs first invented in the 1800s, changing attitudes about pain management over the following decades, and the implementation of the pain scale at the beginning of the twenty-first century. He explores both the science of addiction and the systemic and cultural barriers we must overcome if we are to address the problem effectively in the contemporary American healthcare system.In Pain in America is not only a gripping personal account of dependence, but a groundbreaking exploration of the intractable causes of America’s opioid problem and their implications for resolving the crisis. Rieder makes clear that the opioid crisis exists against a backdrop of real, debilitating pain—and that anyone can fall victim to this epidemic.

Cows, Pigs, Wars, and Witches: The Riddles of Culture


Marvin Harris - 1974
    The author shows that no matter how bizarre a people's behavior may seem, it always stems from concrete social and economic conditions. It is by isolating and identifying these conditions that we will be able to understand and cope with some of our own apparently senseless life styles. In a devastating attack on the shamans of the counterculture, the author states the case for a return to objective consciousness and a rational set of political commitments.

Money-Driven Medicine: The Real Reason Health Care Costs So Much


Maggie Mahar - 2006
    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.

Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty


Abhijit V. Banerjee - 2011
    But much of their work is based on assumptions that are untested generalizations at best, harmful misperceptions at worst.Abhijit Banerjee and Esther Duflo have pioneered the use of randomized control trials in development economics. Work based on these principles, supervised by the Poverty Action Lab, is being carried out in dozens of countries. Drawing on this and their 15 years of research from Chile to India, Kenya to Indonesia, they have identified wholly new aspects of the behavior of poor people, their needs, and the way that aid or financial investment can affect their lives. Their work defies certain presumptions: that microfinance is a cure-all, that schooling equals learning, that poverty at the level of 99 cents a day is just a more extreme version of the experience any of us have when our income falls uncomfortably low.This important book illuminates how the poor live, and offers all of us an opportunity to think of a world beyond poverty.Learn more at www.pooreconomics.com

Twelve Patients: Life and Death at Bellevue Hospital


Eric Manheimer - 2012
    Dr. Manheimer describes the plights of twelve very different patients--from dignitaries at the nearby UN, to supermax prisoners at Riker's Island, to illegal immigrants, and Wall Street tycoons.Manheimer was not only the medical director of the country's oldest public hospital for over 13 years, but he was also a patient. As the book unfolds, the narrator is diagnosed with cancer, and he is forced to wrestle with the end of his own life even as he struggles to save the lives of others.

The American Plague: The Untold Story of Yellow Fever, the Epidemic That Shaped Our History


Molly Caldwell Crosby - 2006
    Carried along the mighty Mississippi River, it ravaged towns from New Orleans to St. Louis. New York City lost 2,000 lives in one year alone. It even forced the nation's capital to relocate from Philadelphia to Washington, DC. "The American Plague" reveals the true story of yellow fever, recounting Memphis, Tennessee's near-destruction and resurrection from the epidemic-and the four men who changed medical history with their battle against an invisible foe that remains a threat to this very day.

Nobody's Normal: How Culture Created the Stigma of Mental Illness


Roy Richard Grinker - 2021
    In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy.Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma. The preeminent historian of medicine, Sander Gilman, calls Nobody’s Normal “the most important work on stigma in more than half a century.”

Life Beside Itself: Imagining Care in the Canadian Arctic


Lisa Stevenson - 2014
    Along the way, Stevenson troubles our commonsense understanding of what life is and what it means to care for the life of another. Through close attention to the images in which we think and dream and through which we understand the world, Stevenson describes a world in which life is beside itself: the name-soul of a teenager who dies in a crash lives again in his friend’s newborn baby, a young girl shares a last smoke with a dead friend in a dream, and the possessed hands of a clock spin uncontrollably over its face. In these contexts, humanitarian policies make little sense because they attempt to save lives by merely keeping a body alive. For the Inuit, and perhaps for all of us, life is "somewhere else," and the task is to articulate forms of care for others that are adequate to that truth.

The Demon Under the Microscope: From Battlefield Hospitals to Nazi Labs, One Doctor's Heroic Search for the World's First Miracle Drug


Thomas Hager - 2006
    The Allies won the war with it. It conquered diseases, changed laws, and single-handedly launched the era of antibiotics. This incredible discovery was sulfa, the first antibiotic. In The Demon Under the Microscope, Thomas Hager chronicles the dramatic history of the drug that shaped modern medicine.Sulfa saved millions of lives—among them those of Winston Churchill and Franklin Delano Roosevelt Jr.—but its real effects are even more far reaching. Sulfa changed the way new drugs were developed, approved, and sold; transformed the way doctors treated patients; and ushered in the era of modern medicine. The very concept that chemicals created in a lab could cure disease revolutionized medicine, taking it from the treatment of symptoms and discomfort to the eradication of the root cause of illness. A strange and colorful story, The Demon Under the Microscope illuminates the vivid characters, corporate strategy, individual idealism, careful planning, lucky breaks, cynicism, heroism, greed, hard work, and the central (though mistaken) idea that brought sulfa to the world. This is a fascinating scientific tale with all the excitement and intrigue of a great suspense novel. For thousands of years, humans had sought medicines with which they could defeat contagion, and they had slowly, painstakingly, won a few battles: some vaccines to ward off disease, a handful of antitoxins. A drug or two was available that could stop parasitic diseases once they hit, tropical maladies like malaria and sleeping sickness. But the great killers of Europe, North America, and most of Asia—pneumonia, plague, tuberculosis, diphtheria, cholera, meningitis—were caused not by parasites but by bacteria, much smaller, far different microorganisms. By 1931, nothing on earth could stop a bacterial infection once it started. . . .But all that was about to change. . . . —from The Demon Under the Microscope