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.
Dreamland: The True Tale of America's Opiate Epidemic
Sam Quinones - 2015
Communities where heroin had never been seen before—from Charlotte, NC and Huntington, WVA, to Salt Lake City and Portland, OR—were overrun with it. Local police and residents were stunned. How could heroin, long considered a drug found only in the dense, urban environments along the East Coast, and trafficked into the United States by enormous Colombian drug cartels, be so incredibly ubiquitous in the American heartland? Who was bringing it here, and perhaps more importantly, why were so many townspeople suddenly eager for the comparatively cheap high it offered?With the same dramatic drive of El Narco and Methland, Sam Quinones weaves together two classic tales of American capitalism: The stories of young men in Mexico, independent of the drug cartels, in search of their own American Dream via the fast and enormous profits of trafficking cheap black-tar heroin to America’s rural and suburban addicts; and that of Purdue Pharma in Stamford, Connecticut, determined to corner the market on pain with its new and expensive miracle drug, Oxycontin; extremely addictive in its own right. Quinones illuminates just how these two stories fit together as cause and effect: hooked on costly Oxycontin, American addicts were lured to much cheaper black tar heroin and its powerful and dangerous long-lasting high. Embroiled alongside the suppliers and buyers are DEA agents, local, small-town sheriffs, and the US attorney from eastern Virginia whose case against Purdue Pharma and Oxycontin made him an enemy of the Bush-era Justice Department, ultimately stalling and destroying his career in public service.Dreamland is a scathing and incendiary account of drug culture and addiction spreading to every part of the American landscape.
The Common Good
Robert B. Reich - 2018
Reich makes the case for a generous, inclusive understanding of the American project, centering on the moral obligations of citizenship. Rooting his argument in everyday reality and common sense, Reich demonstrates the existence of a common good, and argues that it is this that defines a society or a nation. Societies and nations undergo virtuous cycles that reinforce and build the common good, as well as vicious cycles that undermine it. Over the course of the past five decades, Reich contends, America has been in a slowly accelerating vicious cycle--one that can and must be reversed. But first we need to weigh what really matters, and how we as a country should relate to honor, shame, patriotism, truth, and the meaning of leadership.Powerful, urgent, and utterly vital, this is a heartfelt missive from one of our foremost political thinkers: a fundamental statement about the purpose of society and a cri de coeur to save America's soul.
Cheap: The High Cost of Discount Culture
Ellen Ruppel Shell - 2009
This pervasive yet little examined obsession is arguably the most powerful and devastating market force of our time-the engine of globalization, outsourcing, planned obsolescence, and economic instability in an increasingly unsettled world. Low price is so alluring that we may have forgotten how thoroughly we once distrusted it. Ellen Ruppel Shell traces the birth of the bargain as we know it from the Industrial Revolution to the assembly line and beyond, homing in on a number of colorful characters, such as Gene Verkauf (his name is Yiddish for "to sell"), founder of E. J. Korvette, the discount chain that helped wean customers off traditional notions of value. The rise of the chain store in post-Depression America led to the extolling of convenience over quality, and big-box retailers completed the reeducation of the American consumer by making them prize low price in the way they once prized durability and craftsmanship. The effects of this insidious perceptual shift are vast: a blighted landscape, escalating debt (both personal and national), stagnating incomes, fraying communities, and a host of other socioeconomic ills. That's a long list of charges, and it runs counter to orthodox economics which argues that low price powers productivity by stimulating a brisk free market. But Shell marshals evidence from a wide range of fields-history, sociology, marketing, psychology, even economics itself-to upend the conventional wisdom. Cheap also unveils the fascinating and unsettling illogic that underpins our bargain-hunting reflex and explains how our deep-rooted need for bargains colors every aspect of our psyches and social lives. In this myth-shattering, closely reasoned, and exhaustively reported investigation, Shell exposes the astronomically high cost of cheap.
Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital
David M. Oshinsky - 2016
From its origins in 1738 as an almshouse and pesthouse, Bellevue today is a revered public hospital bringing first-class care to anyone in need. With its diverse, ailing, and unprotesting patient population, the hospital was a natural laboratory for the nation's first clinical research. It treated tens of thousands of Civil War soldiers, launched the first civilian ambulance corps and the first nursing school for women, pioneered medical photography and psychiatric treatment, and spurred New York City to establish the country's first official Board of Health. As medical technology advanced, "voluntary" hospitals began to seek out patients willing to pay for their care. For charity cases, it was left to Bellevue to fill the void. The latter decades of the twentieth century brought rampant crime, drug addiction, and homelessness to the nation's struggling cities problems that called a public hospital's very survival into question. It took the AIDS crisis to cement Bellevue's enduring place as New York's ultimate safety net, the iconic hospital of last resort.
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.
Bad Pharma: How Drug Companies Mislead Doctors and Harm Patients
Ben Goldacre - 2012
We like to imagine that it’s based on evidence and the results of fair tests. In reality, those tests are often profoundly flawed. We like to imagine that doctors are familiar with the research literature surrounding a drug, when in reality much of the research is hidden from them by drug companies. We like to imagine that doctors are impartially educated, when in reality much of their education is funded by industry. We like to imagine that regulators let only effective drugs onto the market, when in reality they approve hopeless drugs, with data on side effects casually withheld from doctors and patients.All these problems have been protected from public scrutiny because they’re too complex to capture in a sound bite. But Dr. Ben Goldacre shows that the true scale of this murderous disaster fully reveals itself only when the details are untangled. He believes we should all be able to understand precisely how data manipulation works and how research misconduct on a global scale affects us. In his own words, “the tricks and distortions documented in these pages are beautiful, intricate, and fascinating in their details.” With Goldacre’s characteristic flair and a forensic attention to detail, Bad Pharma reveals a shockingly broken system and calls for something to be done. This is the pharmaceutical industry as it has never been seen before.
American Overdose: The Opioid Tragedy in Three Acts
Chris McGreal - 2018
But American Overdose exposes the powerful forces they were up against, including the pharmaceutical industry's coopting of the Food and Drug Administration and Congress in the drive to push painkillers--resulting in the resurgence of heroin cartels in the American heartland. McGreal tells the story, in terms both broad and intimate, of people hit by a catastrophe they never saw coming. Years in the making, its ruinous consequences will stretch years into the future.
Empire of Pain: The Secret History of the Sackler Dynasty
Patrick Radden KeefePatrick Radden Keefe - 2021
The Sackler name adorns the walls of many storied institutions: Harvard, the Metropolitan Museum of Art, Oxford, the Louvre. They are one of the richest families in the world, known for their lavish donations to the arts and sciences. The source of the family fortune was vague, however, until it emerged that the Sacklers were responsible for making and marketing OxyContin, a blockbuster painkiller that was a catalyst for the opioid crisis.Empire of Pain is a masterpiece of narrative reporting and writing, exhaustively documented and ferociously compelling.
Toms River: A Story of Science and Salvation
Dan Fagin - 2013
Eight years later, a schoolteacher who lived four miles away gave birth to a boy whose cherubic smile belied the fast growing tumors that soon riddled his face and chest. The doctors predicted he would not reach his first birthday. They were wrong, but that was only one of many surprises that would eventually come to light in Toms River, culminating in 2001 with a record legal settlement believed to top $35 million and an unprecedented government study confirming the existence of a long-suspected cluster of childhood cancer linked to polluted water and air. A detective story rooted in a scientific quest thousands of years old, Toms River is a tale of dumpers at midnight and deceptions in broad daylight, of corporate avarice and government neglect, and of a few brave individuals who would not keep silent.
The Panic Virus: A True Story of Medicine, Science, and Fear
Seth Mnookin - 2011
The media seized hold of the story and, in the process, helped to launch one of the most devastating health scares ever. In the years to come Wakefield would be revealed as a profiteer in league with class-action lawyers, and he would eventually lose his medical license. Meanwhile, one study after another failed to find any link between childhood vaccines and autism. Yet the myth that vaccines somehow cause developmental disorders lives on. Despite the lack of corroborating evidence, it has been popularized by media personalities such as Oprah Winfrey and Jenny McCarthy and legitimized by journalists who claim that they are just being fair to “both sides” of an issue about which there is little debate. Meanwhile, millions of dollars have been diverted from potential breakthroughs in autism research; families have spent their savings on ineffective “miracle cures"; and declining vaccination rates have led to outbreaks of deadly illnesses like Hib, measles, and whooping cough. Most tragic of all is the increasing number of children dying from vaccine-preventable diseases. In The Panic Virus Seth Mnookin draws on interviews with parents, public-health advocates, scientists, and anti-vaccine activists to tackle a fundamental question: How do we decide what the truth is? The fascinating answer helps explain everything from the persistence of conspiracy theories about 9/11 to the appeal of talk-show hosts who demand that President Obama “prove” he was born in America. The Panic Virus is the ultimate cautionary tale for our time.
And the Band Played On: Politics, People, and the AIDS Epidemic
Randy Shilts - 1987
America faced a troubling question: What happened? How was this epidemic allowed to spread so far before it was taken seriously? In answering these questions, Shilts weaves the disparate threads into a coherent story, pinning down every evasion and contradiction at the highest levels of the medical, political, and media establishments. Shilts shows that the epidemic spread wildly because the federal government put budget ahead of the nation's welfare; health authorities placed political expediency before the public health; and scientists were often more concerned with international prestige than saving lives. Against this backdrop, Shilts tells the heroic stories of individuals in science and politics, public health and the gay community, who struggled to alert the nation to the enormity of the danger it faced. And the Band Played On is both a tribute to these heroic people and a stinging indictment of the institutions that failed the nation so badly.
The Death of Truth: Notes on Falsehood in the Age of Trump
Michiko Kakutani - 2018
Over the last three decades, Michiko Kakutani has been thinking and writing about the demise of objective truth in popular culture, academia, and contemporary politics. In The Death of Truth, she connects the dots to reveal the slow march of untruth up to our present moment, when Red State and Blue State America have little common ground, proven science is once more up for debate, and all opinions are held to be equally valid. (And, more often than not, rudely declared online.) The wisdom of the crowd has diminished the power of research and expertise, and we are each left clinging to the "facts" that best confirm our biases.With wit, erudition, and remarkable insight, Kakutani offers a provocative diagnosis of our current condition and presents a path forward for our truth-challenged times.
The Premonition: A Pandemic Story
Michael Lewis - 2021
But the president insisted there was nothing to worry about.Fortunately, we are still a nation of skeptics. Fortunately, there are those among us who study pandemics and are willing to look unflinchingly at worst-case scenarios. Michael Lewis’s taut and brilliant nonfiction thriller pits a band of medical visionaries against the wall of ignorance that was the official response of the Trump administration to the outbreak of COVID-19.The characters you will meet in these pages are as fascinating as they are unexpected. A thirteen-year-old girl’s science project on transmission of an airborne pathogen develops into a very grown-up model of disease control. A local public-health officer uses her worm’s-eye view to see what the CDC misses, and reveals great truths about American society. A secret team of dissenting doctors, nicknamed the Wolverines, has everything necessary to fight the pandemic: brilliant backgrounds, world-class labs, prior experience with the pandemic scares of bird flu and swine flu…everything, that is, except official permission to implement their work.Michael Lewis is not shy about calling these people heroes for their refusal to follow directives that they know to be based on misinformation and bad science. Even the internet, as crucial as it is to their exchange of ideas, poses a risk to them. They never know for sure who else might be listening in.