A detailed and innovative blueprint for fixing what ails American medicine.
Time to radically revamp the American health care system in light of the flawed response to the Covid-19 pandemic and many other dysfunctions, argues this sweeping manifesto.
Kapur, a public policy professor at the University of Maryland College Park, and debut author Chalil, a physician and chairman of the Indo American Press Club, start by noting medical difficulties faced by the United States during the Covid-19 pandemic. These include shortages of masks, personal protective equipment, and ventilators; mass layoffs that caused people to lose their insurance; and bankruptcies among some hospitals that suspended elective procedures to make way for virus cases. They continue with a wide-ranging critique of American medicine, spotlighting its higher costs and poorer health outcomes compared to other developed countries; the lack of accessibility of needy and uninsured patients; shortages of hospitals, doctors, and nurses; and the pressure on providers to improve profits by cutting corners and to defend against malpractice suits with unnecessary tests. To remedy these problems, the authors propose a “Grand Plan To Restructure Healthcare in the U.S.” with a mix of public provisions and market-based competition. They envision a “SafetyNet” of public county hospitals providing basic care to all regardless of insurance or ability to pay. A second system of private hospitals, providers, and insurance, funded by “Enhanced Health Savings Accounts,” would run in parallel and compete in price and quality in a national and global market, with medical services advertised like groceries, complete with coupons. Other plan features include a unitary electronic medical record, caps on malpractice damages, a Comprehensive Consumer Healthcare Score that awards points for healthy lifestyles that could lower insurance rates, initiatives to train more health care professionals, a National Strategic Healthcare Reserve of emergency supplies, and new technologies, from online diagnosis to medical robots.
Kapur and Chalil present their case for far-reaching reforms of American health care in lucid prose that has an incisive bite. (“Calling it a healthcare system is a misnomer. It is a disease-care system, one that focuses on diagnosing and treating symptoms instead of taking on the job of educating individuals and families to take a proactive approach to their health.”) But the book suffers from a meandering, repetitive structure and an occasional lack of focus and rigor; it pursues tangents that some readers may consider dubious, like a brief for traditional Indian ayurvedic healing as an adjunct to Western medicine; and it sometimes gets facts wrong. (The 1918 Spanish flu did not kill “a third of the world’s population”—mortality was between 1% and 6%—and British Prime Minister Boris Johnson did not “support a herd immunity theory until he was hospitalized with the COVID-19 virus”; he imposed a national lockdown to prevent contagion on March 20, 2020, seven days before he tested positive.) The authors’ plan is something of a hodgepodge, with myriad moving parts to achieve many disparate goals, and it’s hazy on some important points, like the costs and funding mechanisms of the public SafetyNet hospitals. Still, Kapur and Chalil manage to steer clear of the dogmas of the right and left to offer a thoughtful, cogent analysis of the manifold problems in the U.S. health care establishment and a wealth of concrete proposals for dealing with them.
A detailed and innovative blueprint for fixing what ails American medicine.Pub Date: Oct. 5, 2020
ISBN: 978-1-7359048-0-1
Page Count: 276
Publisher: TheUNN Corporation
Review Posted Online: Feb. 8, 2021
Kirkus Reviews Issue: March 15, 2021
Review Program: Kirkus Indie
An incisive, urgently relevant analysis of—and call to action on—America’s foundational ideal.
An examination of how the U.S. can revitalize its commitment to freedom.
In this ambitious study, Snyder, author of On Tyranny, The Road to Unfreedom, and other books, explores how American freedom might be reconceived not simply in negative terms—as freedom from coercion, especially by the state—but positive ones: the freedom to develop our human potential within sustaining communal structures. The author blends extensive personal reflections on his own evolving understanding of liberty with definitions of the concept by a range of philosophers, historians, politicians, and social activists. Americans, he explains, often wrongly assume that freedom simply means the removal of some barrier: “An individual is free, we think, when the government is out of the way. Negative freedom is our common sense.” In his careful and impassioned description of the profound implications of this conceptual limitation, Snyder provides a compelling account of the circumstances necessary for the realization of positive freedom, along with a set of detailed recommendations for specific sociopolitical reforms and policy initiatives. “We have to see freedom as positive, as beginning from virtues, as shared among people, and as built into institutions,” he writes. The author argues that it’s absurd to think of government as the enemy of freedom; instead, we ought to reimagine how a strong government might focus on creating the appropriate conditions for human flourishing and genuine liberty. Another essential and overlooked element of freedom is the fostering of a culture of solidarity, in which an awareness of and concern for the disadvantaged becomes a guiding virtue. Particularly striking and persuasive are the sections devoted to eviscerating the false promises of libertarianism, exposing the brutal injustices of the nation’s penitentiaries, and documenting the wide-ranging pathologies that flow from a tax system favoring the ultrawealthy.
An incisive, urgently relevant analysis of—and call to action on—America’s foundational ideal.Pub Date: Sept. 17, 2024
ISBN: 9780593728727
Page Count: 368
Publisher: Crown
Review Posted Online: June 25, 2024
Kirkus Reviews Issue: Aug. 1, 2024
A revelatory meditation on shattering journeys.
Bearing witness to oppression.
Award-winning journalist and MacArthur Fellow Coates probes the narratives that shape our perception of the world through his reports on three journeys: to Dakar, Senegal, the last stop for Black Africans “before the genocide and rebirth of the Middle Passage”; to Chapin, South Carolina, where controversy erupted over a writing teacher’s use of Between the World and Me in class; and to Israel and Palestine, where he spent 10 days in a “Holy Land of barbed wire, settlers, and outrageous guns.” By addressing the essays to students in his writing workshop at Howard University in 2022, Coates makes a literary choice similar to the letter to his son that informed Between the World and Me; as in that book, the choice creates a sense of intimacy between writer and reader. Interweaving autobiography and reportage, Coates examines race, his identity as a Black American, and his role as a public intellectual. In Dakar, he is haunted by ghosts of his ancestors and “the shade of Niggerology,” a pseudoscientific narrative put forth to justify enslavement by portraying Blacks as inferior. In South Carolina, the 22-acre State House grounds, dotted with Confederate statues, continue to impart a narrative of white supremacy. His trip to the Middle East inspires the longest and most impassioned essay: “I don’t think I ever, in my life, felt the glare of racism burn stranger and more intense than in Israel,” he writes. In his complex analysis, he sees the trauma of the Holocaust playing a role in Israel’s tactics in the Middle East: “The wars against the Palestinians and their Arab allies were a kind of theater in which ‘weak Jews’ who went ‘like lambs to slaughter’ were supplanted by Israelis who would ‘fight back.’” Roiled by what he witnessed, Coates feels speechless, unable to adequately convey Palestinians’ agony; their reality “demands new messengers, tasked as we all are, with nothing less than saving the world.”
A revelatory meditation on shattering journeys.Pub Date: Oct. 1, 2024
ISBN: 9780593230381
Page Count: 176
Publisher: One World/Random House
Review Posted Online: Aug. 2, 2024
Kirkus Reviews Issue: Sept. 1, 2024
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