Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price


Jonathan Cohn - 2007
    Every day, millions of hard-working people struggle to find affordable medical treatment for themselves and their families—unable to pay for prescription drugs and regular checkups, let alone hospital visits. Some of these people end up losing money. Others end up losing something even more valuable: their health or even their lives. In this powerful work of original reportage, Jonathan Cohn travels across the United States—the only country in the developed world that does not guarantee access to medical care as a right of citizenship—to investigate why this crisis is happening and to see firsthand its impact on ordinary Americans.The stories he brings back are tragic and infuriating. In Boston, a heart attack victim becomes a casualty of emergency room overcrowding when she is turned away from the one hospital that could treat her. In South Central L.A., a security guard loses part of his vision when he can't find affordable treatment for his diabetes. In the middle of the prairie heartland, a retired meatpacker sells his house to pay for the medications that keep him and his aging wife alive. And, in a tiny village tucked into the Catskill mountains, a mother of three young children decides against a costly doctor's visit—and lets a deadly cancer go undetected—because her husband's high-tech job no longer provides health insurance.Passionate, illuminating, and often devastating, Sick interweaves these stories with clear-eyed reporting from Washington and takes us inside the medical industry to chronicle the decline of America's health care system—and lays bare the consequences any one of us could suffer if we don't replace it.

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?

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.

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.

The Primal Prescription: Surviving The "Sick Care" Sinkhole


Doug McGuff - 2015
    health care system is in a state of disrepair, but the rabbit hole goes deeper than even the staunchest critics may realize. In Primal Prescription, authors Doug McGuff and Robert Murphy combine their expertise in economics and medicine to offer a shocking, disturbing, and ultimately enlightening view into America’s health care system. You’ll discover the real history of what went wrong with U.S. health care and insurance, and why current efforts to clean up the mess are only making things worse.But far from leaving you feeling helpless at the dismal—and sometimes deadly—state of affairs, Primal Prescription equips you with both the knowledge to understand the health care conundrum and the tools for navigating your way out of it. McGuff and Murphy offer an evidence-based “game plan” for taking control of your own medical care, protecting yourself and your loved ones regardless of what the future holds for the rest of the nation.Whether you’re currently tangled in America’s broken health care system or simply trying to avoid its clutches, Primal Prescription is a must-have resource for taking your health into your own hands.

American Psychosis: How the Federal Government Destroyed the Mental Illness Treatment System


E. Fuller Torrey - 2013
    Kennedy delivered an historic speech on mental illness and retardation. He described sweeping new programs to replace "the shabby treatment of the many millions of the mentally disabled in custodial institutions" with treatment in community mental health centers. This movement, later referred to as "deinstitutionalization," continues to impact mental health care. Though he never publicly acknowledged it, the program was a tribute to Kennedy's sister Rosemary, who was born mildly retarded and developed a schizophrenia-like illness. Terrified she'd become pregnant, Joseph Kennedy arranged for his daughter to receive a lobotomy, which was a disaster and left her severely retarded. Fifty years after Kennedy's speech, E. Fuller Torrey's book provides an inside perspective on the birth of the federal mental health program. On staff at the National Institute of Mental Health when the program was being developed and implemented, Torrey draws on his own first-hand account of the creation and launch of the program, extensive research, one-on-one interviews with people involved, and recently unearthed audiotapes of interviews with major figures involved in the legislation. As such, this book provides historical material previously unavailable to the public. Torrey examines the Kennedys' involvement in the policy, the role of major players, the responsibility of the state versus the federal government in caring for the mentally ill, the political maneuverings required to pass the legislation, and how closing institutions resulted not in better care - as was the aim - but in underfunded programs, neglect, and higher rates of community violence. Many now wonder why public mental illness services are so ineffective. At least one-third of the homeless are seriously mentally ill, jails and prisons are grossly overcrowded, largely because the seriously mentally ill constitute 20 percent of prisoners, and public facilities are overrun by untreated individuals. As Torrey argues, it is imperative to understand how we got here in order to move forward towards providing better care for the most vulnerable.

The American Way of Poverty: How the Other Half Still Lives


Sasha Abramsky - 2013
    It is made up of both the long-term chronically poor and new working poor—the tens of millions of victims of a broken economy and an ever more dysfunctional political system. In many ways, for the majority of Americans, financial insecurity has become the new norm.The American Way of Poverty shines a light on this travesty. Sasha Abramsky brings the effects of economic inequality out of the shadows and, ultimately, suggests ways for moving toward a fairer and more equitable social contract. Exploring everything from housing policy to wage protections and affordable higher education, Abramsky lays out a panoramic blueprint for a reinvigorated political process that, in turn, will pave the way for a renewed War on Poverty.It is, Harrington believed, a moral outrage that in a country as wealthy as America, so many people could be so poor. Written in the wake of the 2008 financial collapse, in an era of grotesque economic extremes, The American Way of Poverty brings that same powerful indignation to the topic.

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.

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.

An Imperfect Offering: Humanitarian Action in the Twenty-first Century


James Orbinski - 2008
    . . . The only crime equaling inhumanity is the crime of indifference, silence, and forgetting.—James OrbinskiIn 1988, James Orbinski, then a medical student in his twenties, embarked on a year-long research trip to Rwanda, a trip that would change who he would be as a doctor and as a man. Investigating the conditions of pediatric AIDS in Rwanda, James confronted widespread pain and suffering, much of it preventable, much of it occasioned by political and economic corruption. Fuelled by the injustice of what he had seen in Rwanda, Orbinski helped establish the Canadian chapter of Médecins Sans Frontières (Doctors Without Borders/MSF). As a member of MSF he travelled to Peru during a cholera epidemic, to Somalia during the famine and civil war, and to Jalalabad, Afghanistan.In April 1994, James answered a call from the MSF Amsterdam office. Rwandan government soldiers and armed militias of extremist Hutus had begun systematically to murder Tutsis. While other foreigners were evacuated from Rwanda, Orbinski agreed to serve as Chef de Mission for MSF in Kigali. As Rwanda descended into a hell of civil war and genocide, he and his team worked tirelessly, tending to thousands upon thousands of casualties. In fourteen weeks 800,000 men, women and children were exterminated. Half a million people were injured, and millions were displaced. The Rwandan genocide was Orbinski’s undoing. Confronted by indescribable cruelty, he struggled to regain his footing as a doctor, a humanitarian and a man. In the end he chose not to retreat from the world, but resumed his work with MSF, and was the organization’s president when it was awarded the Nobel Peace Prize in 1999.An Imperfect Offering is a deeply personal, deeply political book. With unstinting candor, Orbinski explores the nature of humanitarian action in the twenty-first century, and asserts the fundamental imperative of seeing as human those whose political systems have most brutally failed. He insists that in responding to the suffering of others, we must never lose sight of the dignity of those being helped or deny them the right to act as agents in their own lives. He takes readers on a journey to some of the darkest places of our history but finds there unimaginable acts of courage and empathy. Here he is doctor as witness, recording voices that must be heard around the world; calling on others to meet their responsibility.Ummera, ummera–sha is a Rwandan saying that loosely translated means ‘Courage, courage, my friend–find your courage and let it live.’ It was said to me by a patient at our hospital in Kigali. She was slightly older than middle aged and had been attacked with machetes, her entire body rationally and systematically mutilated. Her face had been so carefully disfigured that a pattern was obvious in the slashes. I could do little more for her at that moment than stop the bleeding with a few sutures. We were completely overwhelmed. She knew and I knew that there were so many others. She said to me in the clearest voice I have ever heard, “Allez, allez. Ummera, ummera-sha”–‘Go, go. Courage, courage, my friend–find your courage and let it live.’—From An Imperfect Offering

The Working Poor: Invisible in America


David K. Shipler - 2004
    Shipler makes clear in this powerful, humane study, the invisible poor are engaged in the activity most respected in American ideology—hard, honest work. But their version of the American Dream is a nightmare: low-paying, dead-end jobs; the profound failure of government to improve upon decaying housing, health care, and education; the failure of families to break the patterns of child abuse and substance abuse. Shipler exposes the interlocking problems by taking us into the sorrowful, infuriating, courageous lives of the poor—white and black, Asian and Latino, citizens and immigrants. We encounter them every day, for they do jobs essential to the American economy.We meet drifting farmworkers in North Carolina, exploited garment workers in New Hampshire, illegal immigrants trapped in the steaming kitchens of Los Angeles restaurants, addicts who struggle into productive work from the cruel streets of the nation's capital—each life another aspect of a confounding, far-reaching urgent national crisis. And unlike mostworks on poverty, this one delves into the calculations of some employers as well—their razor-thin profits, their anxieties about competition from abroad, their frustrations in finding qualified workers.This impassioned book not only dissects the problems, but makes pointed, informed recommendations for change. It is a book that stands to make a difference.

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures


Anne Fadiman - 1997
    By 1988 she was living at home but was brain dead after a tragic cycle of misunderstanding, over-medication, and culture clash: "What the doctors viewed as clinical efficiency the Hmong viewed as frosty arrogance." The Spirit Catches You and You Fall Down is a tragedy of Shakespearean dimensions, written with the deepest of human feeling. Sherwin Nuland said of the account, "There are no villains in Fadiman's tale, just as there are no heroes. People are presented as she saw them, in their humility and their frailty—and their nobility.

The ASEAN Miracle: A Catalyst for Peace


Kishore Mahbubani - 2017
    Why?In an era of growing cultural pessimism, many thoughtful individuals believe that different civilisations – especially Islam and the West – cannot live together in peace. The ten countries of ASEAN provide a thriving counter-example of civilizational co-existence. Here 625m people live together in peace. This miracle was delivered by ASEAN.In an era of growing economic pessimism, where many young people believe that their lives will get worse in coming decades, Southeast Asia bubbles with optimism. In an era where many thinkers predict rising geopolitical competition and tension, ASEAN regularly brings together all the world’s great powers.Stories of peace are told less frequently than stories of conflict and war. ASEAN’s imperfections make better headlines than its achievements. But in the hands of thinker and writer Kishore Mahbubani, the good news story is also a provocation and a challenge to the rest of the world."This excellent book explains, in clear and simple terms, how and why ASEAN has become one of the most successful regional organizations in the world."George Yeo"A powerful and passionate account of how, against all odds, ASEAN transformed the region and why Asia and the world need it even more today."Amitav Acharya“Kishore and I have written that the world is coming together in a Fusion of Civilisations. This book documents beautifully how ASEAN has achieved this fusion. The ASEAN story is hugely instructive and this book tells it very well.”Larry SummersKishore Mahbubani is Dean of the Lee Kuan Yew School of Public Policy, National University of Singapore, and author of The New Asian Hemisphere: The Irresistible Shift of Global Power to the East. Jeffery Sng is a writer and former diplomat based in Bangkok, co-author of A History of the Thai-Chinese.

Pathologies of Power: Health, Human Rights and the New War on the Poor


Paul Farmer - 2003
    Paul Farmer, a physician and anthropologist with twenty years of experience working in Haiti, Peru, and Russia, argues that promoting the social and economic rights of the world’s poor is the most important human rights struggle of our times. With passionate eyewitness accounts from the prisons of Russia and the beleaguered villages of Haiti and Chiapas, this book links the lived experiences of individual victims to a broader analysis of structural violence. Farmer challenges conventional thinking within human rights circles and exposes the relationships between political and economic injustice, on one hand, and the suffering and illness of the powerless, on the other.Farmer shows that the same social forces that give rise to epidemic diseases such as HIV and tuberculosis also sculpt risk for human rights violations. He illustrates the ways that racism and gender inequality in the United States are embodied as disease and death. Yet this book is far from a hopeless inventory of abuse. Farmer’s disturbing examples are linked to a guarded optimism that new medical and social technologies will develop in tandem with a more informed sense of social justice. Otherwise, he concludes, we will be guilty of managing social inequality rather than addressing structural violence. Farmer’s urgent plea to think about human rights in the context of global public health and to consider critical issues of quality and access for the world’s poor should be of fundamental concern to a world characterized by the bizarre proximity of surfeit and suffering.