A bombshell of a book: must reading for consumers, their political representatives and all those White House contenders.
Journalist Brownlee blames America’s sky-high healthcare costs on expensive treatments imposed by doctors on patients all too ready to accept or even demand them.
At a time when presidential candidates are asked how they plan to pay for universal healthcare coverage, the author provides reams of data to back up her contention that the real issue is the “dysfunctional, unfair and spectacularly expensive system” we’re already paying for. Unnecessary care is rampant, she concludes. Doctors are coaxed, conditioned or warned that they must prescribe drugs or tests, refer to specialists, put patients in the hospital, operate. If this excessively aggressive approach involves a new drug, device or machine, so much the better: Medicare or another insurer will pay generously for high-ticket items, but not for prevention and advice. Some patients benefit; many do not. Medicare patients living in high-cost, high-care regions are no healthier than their peers in lower-cost, less-care regions. For this conclusion, as for others in the book, Brownlee relies on data from the Dartmouth Atlas of Health Care, an annual compendium that tallies who gets what procedure for what ailment in each region of the country. Overtreatment is a national problem, the author states. Precipitating factors include aggressive physicians; litigious patients ready to sue over any omission; and hospital administrators adding (and filling) surgical wings or ICUs to pay for emergency departments that operate at a loss. Also contributing to the mess are direct advertising to consumers and control of clinical trials by Big Pharma, insufficiently monitored by weak federal agencies charged with regulation and with reviewing the evidence of what works. What to do? Brownlee points to the Veterans Health Administration, which rose from rock bottom in the mid-1990s to become a model health-care provider. Other institutions could achieve similar results, she believes, by implementing a strategy of “CARE”: coordination, accountability, electronic medical records and evidence.
A bombshell of a book: must reading for consumers, their political representatives and all those White House contenders.Pub Date: Sept. 1, 2007
ISBN: 978-1-58234-580-2
Page Count: 320
Publisher: Bloomsbury
Review Posted Online: May 19, 2010
Kirkus Reviews Issue: July 1, 2007
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
However charily one should apply the word, a beautiful book, an unconditionally involving memoir for our time or any time.
Maya Angelou is a natural writer with an inordinate sense of life and she has written an exceptional autobiographical narrative which retrieves her first sixteen years from "the general darkness just beyond the great blinkers of childhood."
Her story is told in scenes, ineluctably moving scenes, from the time when she and her brother were sent by her fancy living parents to Stamps, Arkansas, and a grandmother who had the local Store. Displaced they were and "If growing up is painful for the Southern Black girl, being aware of her displacement is the rust on the razor that threatens the throat." But alternating with all the pain and terror (her rape at the age of eight when in St. Louis With her mother) and humiliation (a brief spell in the kitchen of a white woman who refused to remember her name) and fear (of a lynching—and the time they buried afflicted Uncle Willie under a blanket of vegetables) as well as all the unanswered and unanswerable questions, there are affirmative memories and moments: her charming brother Bailey; her own "unshakable God"; a revival meeting in a tent; her 8th grade graduation; and at the end, when she's sixteen, the birth of a baby. Times When as she says "It seemed that the peace of a day's ending was an assurance that the covenant God made with children, Negroes and the crippled was still in effect."
However charily one should apply the word, a beautiful book, an unconditionally involving memoir for our time or any time.Pub Date: Feb. 1, 1969
ISBN: 0375507892
Page Count: 235
Publisher: Random House
Review Posted Online: May 14, 2012
Kirkus Reviews Issue: Feb. 1, 1969
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SEEN & HEARD
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