An American Sickness: How Healthcare Became Big Business and How You Can Take It Back is a horror show, heavy of the description and analysis of the horror and very light on the solutions. The horror is the US health care system, so incredibly expensive compared to other developed countries and yet yielding such poor results at the population level. The author, a physician turned journalist, cogently describes an industry that is treated as any others but does not obey the normal laws of markets as insurance companies, hospitals, physicians, and the pharmaceutical industry all conspire to increase their profits. I was underwhelmed by the list of “solutions”, which are heavy on patients asking for cost estimates ahead of time and shopping more wisely. Presumably she, with her physician’s background, can both determine which hospitals and physicians to choose and also get an answer to the cost question. Ordinary patients, most probably, cannot.
Tag Archives: medicine
Let’s start with the admission that I was bored by the slow pace of The Vaccine Race: Science, Politics, and the Human Costs of Defeating Disease, which recounts the way the rubella vaccine was created, and in particular how the human cells that it uses were grown. A more patient reader may more fully appreciate the intrigue: fetus lungs shipped across the Atlantic, babies vaccinated without a hint of proper consent, the illegal transfer of thousands of cells across the country, in a refrigerator strapped to the back seat of a family car, and a lawsuit to boot (about the transfer, not those unimportant consent forms).
Mercies in Disguise: A Story of Hope, a Family’s Genetic Destiny, and the Science That Rescued Them tells the story of a family with an awful genetic disease and its members’ struggle to decide whether to submit to a genetic test that will tell them whether they will die after a slow agony in middle age. It’s not a simple question, and the author does a good job of laying out the layered dilemmas facing the family, but I found the breathless suspense overdone and ultimately a turnoff.
Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America is an expose against the dental care system in America, which leaves a sizable minority of Americans without care, and with awful toothaches and infections. The author exposes how dentist associations have fought to keep the equivalent of nurse practitioners banned while allowing Medicaid coverage for dental work to be pretty much useless since few dentists take Medicaid patients at all, and most only a few.
The book is somewhat repetitive and often overly sensational but does a good job of exposing a sad corner of America.
Be patient if you decide to pick up The Gene Machine: How Genetic Technologies Are Changing the Way We Have Kids–and the Kids We Have. It starts slowly, describing standard pregnancy genetic testing techniques that seem mundane — but it ratchets up to much more technically complex and ethically challenging techniques, from preimplantation genetic diagnosis to systematically screening parents for potentially devastating genes. The author does not shy away from discussing how genetic testing is linked to abortions or how to imagine a world in which particular disabilities have become very rare. While definitely not a book to recommend to a pregnant woman, it’s a great way to think about the choices to make as a prospective parent and as a society.
Written by a physician, Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop exposes how shoddy research, a laudable quest to treat pain better, and especially features of the health care system that encourage physicians to acquiesce to patients’ requests and above all get them out of the door combined to overprescribe opioids and create millions of addicts. It’s a sobering story. Besides better education for physicians, it seems that relatively simple measures such as a universal prescription registry (alas implemented state by state) would help, but only a minority of physicians bother to check it…
If you remember the 80s and early 90s when healthy young men would suddenly turn into skeletons and die you will read How to Survive a Plague: The Inside Story of How Citizens and Science Tamed AIDS with sadness for all who died and interest for how small groups of dedicated activists pushed the government and the medical establishment to action and changed the way drug research is conducted while around them their friends and they themselves sickened and died. The story focuses on the New York groups ACT UP and TAG, and refers only briefly to other groups within the country, which is frustrating at times, but the story mixes the personal, intimate experiences of the author and the other actors with the larger narrative in a very effective manner. The later part of the book descends into the internal power struggles of the activist groups, which are just as boring as one would expect, but you can stop reading at any time.