A hard look at how for-profit health management organizations have come to be the force they are in our health care system and how their emphasis on the bottom line threatens quality medical care. Wall Street Journal reporter Anders (Merchants of Debt, 1992) reveals how corporations in the 1980s turned to managed care as a way to hold down the mushrooming costs of employee health plans by taking power away from doctors, hospitals, and patients and putting it in the hands of businessmen. Over 55 million Americans are now covered by HMOs, and their numbers are growing at the rate of 100,000 a week. The entrepreneurs who led the way in this astonishing revolution in our health care system come in for some sharp scrutiny (Anders seems to enjoy deploring their greed and flashy lifestyles), but the main focus is on how HMOs function. Anders examines their impact on hospitals, doctors, the pharmaceutical industry, and of course consumers. Hair-raising stories about the refusal to treat seriously ill patients are featured prominently in his discusion of how cost-conscious HMOs handle heart disease and breast cancer, emergency medicine, mental health, and care of the elderly and the poor. The picture that emerges is disheartening, even alarming, but not hopeless. Anders shows how consumers, doctors, employers, and regulators have been able in specific instances to challenge stingy treatment guidelines, negotiate for better access to specialists, change the rules about use of emergency rooms, and help set better standards of coverage. He concludes by summarizing various courses of action these groups can take to improve the medical care provided by HMOs and by warning HMOs that as society develops a cost-effective medical system, they may find themselves expendable. Highly readable and downright essential for anyone—patient or doctor—in an HMO or considering joining one. (Author tour)
Pub Date: Nov. 13, 1996
ISBN: 0-395-82283-1
Page Count: 288
Publisher: Houghton Mifflin
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: Sept. 1, 1996
Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...
A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.
In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.
Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.Pub Date: Feb. 9, 2010
ISBN: 978-1-4000-5217-2
Page Count: 320
Publisher: Crown
Review Posted Online: Dec. 22, 2010
Kirkus Reviews Issue: Jan. 1, 2010
BOOK REVIEW
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.
“Quality of life means more than just consumption”: Two MIT economists urge that a smarter, more politically aware economics be brought to bear on social issues.
It’s no secret, write Banerjee and Duflo (co-authors: Poor Economics: A Radical Rethinking of the Way To Fight Global Poverty, 2011), that “we seem to have fallen on hard times.” Immigration, trade, inequality, and taxation problems present themselves daily, and they seem to be intractable. Economics can be put to use in figuring out these big-issue questions. Data can be adduced, for example, to answer the question of whether immigration tends to suppress wages. The answer: “There is no evidence low-skilled migration to rich countries drives wage and employment down for the natives.” In fact, it opens up opportunities for those natives by freeing them to look for better work. The problem becomes thornier when it comes to the matter of free trade; as the authors observe, “left-behind people live in left-behind places,” which explains why regional poverty descended on Appalachia when so many manufacturing jobs left for China in the age of globalism, leaving behind not just left-behind people but also people ripe for exploitation by nationalist politicians. The authors add, interestingly, that the same thing occurred in parts of Germany, Spain, and Norway that fell victim to the “China shock.” In what they call a “slightly technical aside,” they build a case for addressing trade issues not with trade wars but with consumption taxes: “It makes no sense to ask agricultural workers to lose their jobs just so steelworkers can keep theirs, which is what tariffs accomplish.” Policymakers might want to consider such counsel, especially when it is coupled with the observation that free trade benefits workers in poor countries but punishes workers in rich ones.
Occasionally wonky but overall a good case for how the dismal science can make the world less—well, dismal.Pub Date: Nov. 12, 2019
ISBN: 978-1-61039-950-0
Page Count: 432
Publisher: PublicAffairs
Review Posted Online: Aug. 28, 2019
Kirkus Reviews Issue: Sept. 15, 2019
SEEN & HEARD
© Copyright 2025 Kirkus Media LLC. All Rights Reserved.
Follow
Popular in this Genre
We can’t wait for you to join Kirkus!
It’s free and takes less than 10 seconds!
Already have an account? Log in.
OR
Sign in with GoogleTrouble signing in? Retrieve credentials.
Welcome Back!
OR
Sign in with GoogleTrouble signing in? Retrieve credentials.
