CRISIS IN U.S. HEALTH CARE

A book examines all aspects of medical care in the United States and how it has changed over the past 60 years.

Geyman (The Human Face of ObamaCare, 2016, etc.) graduated from medical school in 1956. During the subsequent 60 years, he has garnered experience as a rural family physician, a teacher and administrator in three medical schools, and an editor of family medicine journals. He has watched as corporate health behemoths have swallowed up family practice, the traditional bedrock of the relationship between physician and patient: “Family medicine, as the direct descendent of general practice, taking care of patients regardless of age, comprises less than 10 percent of the country’s physician workforce.” The service ethic of medicine, Geyman declares, has been replaced with the “business ethic,” and the result is poorer patient care. Another serious problem he addresses is the skyrocketing cost of health care. High insurance deductibles, extraordinarily escalating pharmaceutical prices, and a tendency on the part of physicians to order excessive tests and procedures to increase compensation have put basic medical care out of reach for millions of Americans. Geyman cites several breathtaking examples regarding prescription costs: the drug Hetlioz, used to treat sleep disorders, costs $148,000 per year. And “hospitals and pharmacies found the prices they had to pay for a bottle of 500 tablets of Doxycycline, a decades-old antibiotic, rose in just six months in 2014 from $20 to $1,849!” This accessible, comprehensive book makes a strong case for a complete overhaul of the U.S. health care system. No fan of the Affordable Care Act, which he says has failed to reduce costs and is a boondoggle for corporate interests, Geyman concludes that the only viable alternative is a single-payer system: “Today’s health care system, serving its corporate masters more than patients, is unfair, ineffective, inhumane for those left out, and financially unsustainable.” The dense volume is occasionally repetitive but lightened a bit by the inclusion of vignettes from the author’s personal practice. Patient anecdotes and commentaries from copious professional sources are compelling.

Articulate, loaded with informative details, especially timely, and bound to leave the reader reaching for a bottle of aspirin.