Yep, I thought so--pharmaceutical advertising and the corporatization of our health system aren't helping any. This book covers those aspects plus many more. The authors draw numbers and statistics from many different agencies, from the WHO to the AMA, to paint a vivid history of health care in America. As a person who has gone without insurance, I knew that I paid more for the same services as someone who did have insurance, but I wasn't aware of the full range of the insured/uninsured pricing scale. When you start getting into the actual numbers, it's pretty amazing. And when you look at the basic stats--average life expectancy per country and how much individual countries spend on health care per year--you'll be (to paraphrase our erstwhile Michigan governor) blown away. Seriously. I had fallen prey to that "but we have the best health care in the world!" syndrome, but I can't see how that's the case when we spend SO much more on it, yet don't live as long as other countries who spend much, much less. The numbers say it all.

Boy! Do I wish I'd had this book and the information inside in 2003! My father was stuck very deep in the mud of the HMO system and trying to fight lung cancer. The doctors were overworked and understaffed, and we had to be his advocate every step of the way. We asked a lot of questions much to their obvious consternation. This book would have helped us to aim our questions with precision, to the appropriate topics, which is hard to do when you're overwelmed with emotions.
So much was explained in this must have handbook, that I have a new clarity of the situation in hindsite.
Thank you Ms. Ehrenclou for your insight! Brillant!

J. Bertolus, Los Angeles

I won't give an exhaustive review as others have done so well. I just wanted to add my voice to those that note this book contains many well-researched examples of just how bad things have become. What the book does not do, however, is give a thorough and balanced look at possible solutions. One must wait until the last chapter, which is quite short, to read about one possible solution - and even this one possibility is not covered in great detail. So, I would recommend you read the book just so you see that, even if your experience has not been bad, it definitely has been very much so for others. But you really will not find "what we should do about it."

I won't give an exhaustive review as others have done so well. I just wanted to add my voice to those that note this book contains many well-researched examples of just how bad things have become. What the book does not do, however, is give a thorough and balanced look at possible solutions. One must wait until the last chapter, which is quite short, to read about one possible solution - and even this one possibility is not covered in great detail. So, I would recommend you read the book just so you see that, even if your experience has not been bad, it definitely has been very much so for others. But you really will not find "what we should do about it."

Wheezy Cough wrote, "If you think healthcare is expensive now, wait until its FREE."




What Wheezy doesn't tell you that Americans ALREADY PAY MORE for their health care than other Western Democracies. If Wheezy were here to defend himself he would probably counter with," Yeah, but American health care is the best." Sorry Wheezy, American health care rates quite low on the list. So Americans in all their wisdom are making payments on a new '05 Mercedes but only getting to drive a '78 Ford LTD. But you see, Wheezy, like most Americans, doesn't travel and really believes he has it the best in all the world. I live in Japan and have also lived in New Zealand and Australia, countries with Universal Health Care, and I would not trade US health care for the worst these countries have to offer. Michael Moore (I am not a fan) wondered why Americans die in such great numbers of gunshot wounds. Well, after living in countries where shooting deaths are a rarity I can offer an answer. People in Japan, UK, Australia, NZ, etc (Did you know that even ISRAEL has universal health care as well, paid for by US taxpayer dollars?) have the option of going to the doctor for help rather than turning to violence. So Whezzy if you ever find yourself with a gun barrel to your head ask yourself if Universal Health Care is as expensive as you thought.

But the complacency that runs rampant in our medical system.I am a patient with three rare diseases and to find a doctor who will take me as a patient is like begging for scraps. I remember a time when to be doctor or in the pharmacy industry was a profession that was honored, where pride was the cornerstone. Now doctor's have lost their will to advocate for the sick and oppressed, they depend upon the pill pushers to tell them what to prescribe. I've been told that there are no more cures anymore, just treatment for the symptoms. Our doctor's offices have turned into pharmaceutical dispensing stations and our hospitals into chop shops. If you any other need, you are just SOL. It is shocking what has become a time that should be enjoyed with grandchildren is spent trying to learn the field of medicine so I can heal myself. No one else wants to.
Peg

It's no secret that American healthcare has some problems. I wanted to get more background on this issue, and I discovered "Critical Condition." I found it to be readable, and it illuminated a number of healthcare crisis points. If you've ever read "The Rainmaker" by John Grisham, you'll have some idea of the stories this book contains. Free market healthcare was touted as the best possible way to ensure low prices and good treatment via competition (oddly enough, by the same guy who came up with the "body count" progress-measurement system in Vietnam.). But the authors contend it has led to higher costs, inferior care, and an uninsured class where millions are only an illness or accident away from financial ruin. And to top it off, the insurance companies have taken away patient care decision-making away from the doctors. I've seen and experienced some of the issues highlighted in "Critical Condition," and I'm appalled that a so-called "hyperpower" has a health care system where families must conduct bake sales to cover medical bills. I commend the authors for illustrating this problem in layman's terms.

However, they aren't so clear when it comes to a solution, and a couple of points stand out. First, the authors criticize efforts to speed up the introduction of new medicines. They argue that some drug companies do this to make a quick buck at the expense of patients. Perhaps they have a point, but on the other hand those with terminal cancer or AIDS have pushed for quicker drug introduction because their lives are on the line. Don't people in this category deserve to take a chance that may save them, especially if they have nothing to lose and everything to gain? Second, they argue for a standard IT system to ease the exchange of medical information. As a healthcare IT tech, I'd love that (although I'd probably end up outsourced as a result). But how? Ideally, you'd have to standardize applications (healthcare and otherwise), hardware platforms, operating systems, etc. Healthcare is a huge information technology market. Can you imagine the joy in Redmond if all US hospital computers had to use Windows XP and Microsoft Office? The Linux folks would blow a gasket, and we'd probably see another Microsoft antitrust suit. And what of the other complex legalities involved? Where I work, conflict of interest barriers have prevented us from linking our computer network with other health systems. "Critical Condition" doesn't address this type of hurdle, or even how HIPAA figures into their ideal information sharing process. Finally, there wasn't much detail on how a single-payer gov't system would be funded, especially with the costs generated by an aging population and illegal immigration. For two guys who go on about how drug companies skip over negative side effects, they should've spent more time on the T-A-X issue and its repercussions. A bullet point or two just doesn't cut it.

Ultimately, Mr. Barlett and Mr. Steele argue that only the federal gov't has the power to dismantle the current massive for-profit healthcare bureaucracy and create a single point of accessible healthcare (although they don't touch on the resulting fallout of job losses this paradigm shift would create). Even so, I would have appreciated some insight into an existing foreign gov't-run healthcare system they favor. They allude to the French and Canadian programs, but offer no breakdown of why or how their systems are superior (or possibly inferior) to ours. But despite their assertions, the authors reject a single-payer U.S. gov't run health plan as politically impossible. Instead, they call for a Federal Reserve-type quasi-gov't system to create a single health care entity (a bit ironic, given the book's anti-market theme. And how can it be "quasigovernmental?" I confess I don't quite grasp the nuances involved here.). I can buy into that avenue of approach, as long as this agency has the power to provide good, affordable care to everyone, create a manageable bureaucracy, and enforce patient and doctor-centric healthcare laws. Easier said than done, however. If the Clintons couldn't reform our health care system during their eight years in office, and the Republicans don't seem to see reformation as a big priority, then how will positive change occur?

There are countless historical examples of the Biblical admonition that "the love of money is the root of all kinds of evil." Free market healthcare has created an environment where it's too easy for this weakness in human nature to overwhelm the altruistic focus of medicine. "Critical Condition" admirably illustrates this problem, but a more comprehensive analysis and realistic solution will have to be found elsewhere.

Over 40,000,000 Americans have no health insurance and many more millions are underinsured. Health Care in America has become big business with a primary focus of making a big profit. The free market is great for America, but is does not work for health care. The reason the free market does not work for health care is that the health care consumer in many cases is not making a real choice. The consumer that is rushed to the hospital has little or no free market choice. In any critical situation the person needing health care does not have free choice when facing life or death or any other critical situation.

There is a big difference between health care and other goods and services where a consumer has a real choice. The market system does not work for health care. Our system is not about health care, but it is about the insurance reimbursement system. The USA health care system is a huge bureaucracy where billions of dollars are spent on the huge bureaucracy that has nothing to do with basic preventative and life-savings care.

The leading cause of death in the USA is heart disease and has been so for decades. The second leading cause is cancer and has been so for decades. The third leading cause of death in the USA is new. It is shocking to now learn from this book that the third leading cause of death is now medical mistakes including drug interactions and bad drugs.

For those that are interested there is an author event for this book available on C-Span2 Book TV.

It's good that someone can protest the current health care hell, since the forty-five million with no voice or medical insurance are never heard. This depiction of the deteriorating scenario of free-market capitalism applied to the distribution of medical services is pretty shocking, something we already know or sense but put from our minds--the plight of those suffering maximu neglect as they finally reach the emergency, and many other horrors in the lottery of this immense swindle worthy of a banana republic. Almost pitiful is the picture of the way those with the least resources are often stuck with massive hospital bills, far greater than the norm for providers. That's unbelievable, as if the way the regime has made it seem normal. Now what do we do about it?

Lots of good points in this book, but each is illustrated with too many personal anecdotes of people who were victims in different ways. I get the point without all the hard luck stories going on for page after page.

This book is an important read, but could have been a lot shorter.