Bitter Medicine: Greed and Chaos in American Health Care - Hardcover

Kassler, Jeanne, M.D.

Hardcover

ISBN 10: 1559722231 ISBN 13: 9781559722230

Publisher: Birch Lane Pr, 1994

Synopsis

For all the talk of health-care reform, few people are willing to expose the facts. Here is a doctor's hard look at how things went wrong in the first place, at how our system landed in intensive care. Instead of yet another policymaker's proposal for change, Bitter Medicine is an explosive examination of our current crisis. This book warns that a cure can come only after we understand the real history and illness of the patient, in this case our health-care system.
With remarkable depth and breadth of research, bold journalistic insight, and extensive firsthand experience working with patients, insurance companies, the federal Medicare program, and many other medical players, Dr. Jeanne Kassler charts in these pages the rise of our unique system - one in which corporate agendas increasingly determine the care we get.
Dr. Kassler explains, for example, how the business of kidney dialysis has flourished, with 30-percent profit margins underwritten by taxpayer revenue. Compensation for one executive of that industry topped $26 million for a three-year period, yet we have chosen not to pay $160 for a mammogram that might have saved a forty-fife-year-old woman's life. Dr Kassler describes how high technology and the profit motive have given us increasingly sophisticated care for a steadily shrinking segment of society. How we have turned our backs on providing basic health care fairly and have neglected education, housing, and other factors that in the long run may make a bigger difference to our collective health.
Bitter Medicine is an incisive, insider's report on the condition of American health care. Its facts, figures, and often galling real-life examples will inform and inflame, and spur more rational debate in Washington and in town halls, boardrooms, and backyards across this country. Here, finally, is a book that makes us ask what we want from medicine - and what tradeoffs we may be forced to make.

About this title

From Kirkus Reviews:

Its subtitle notwithstanding, this is not a polemic but a cool and balanced analysis of our ailing health care system. An internist and journalist, Kassler (Gay Men's Health, 1983) approaches the system as though it were a patient--taking its history, noting its chief complaints, examining it, and then coming up with a diagnosis and plan of treatment. The history shows that the system underwent enormous change when third-party payers severed the connection between receiving care and paying for it. After identifying the system's chief complaints as spiraling costs, access problems, insurance hassles, the vanishing family doctor, and loss of privacy, Kassler examines the system's many players. First to come under her critical eye are the multitude of new industries spawned by the availability of huge funds from Medicare and Medicaid. Then she deftly probes the pharmaceutical industry; the medical profession; the media, especially for its part in boosting public demand for high-tech medical services; society's changing values; the government's multiple and complex roles; and the effects of the legal system. Her assessment is that the health care system is becoming too expensive and exclusionary and that we must create something stable, fair, and flexible. To do so, she says, requires setting some general goals: stabilize costs, provide universal care, ensure medical advances, take the anxiety out of the system. She proposes some broadly defined steps toward reaching these goals: pool our risks, maximize choice, move to community-based primary care, demedicalize social problems, separate insurance from employment. Her approach is holistic--working on all parts of the system to ``nudge all players toward reform.'' In a brief epilogue, she takes issue with many of the Clinton plan's specifics. Highly recommended--convincing and comprehensive. -- Copyright ©1994, Kirkus Associates, LP. All rights reserved.

From Library Journal:

Kassler, an internist and journalist, scrutinizes the healthcare crisis using the analytical tools of a medical practitioner. The symptoms are familiar: skyrocketing costs for government, business, and individuals; increasing numbers of uninsured and underinsured Americans; and diminished public confidence in the U.S. healthcare system. The diagnosis is not surprising: too many tests and procedures; neglect of public health; exploding malpractice litigation; irrational government regulations; and rapacious insurance and pharmaceutical corporations. The treatment will be, unfortunately, complex. Kassler's prescriptions include an emphasis on community medicine, the separation of insurance from employment, and a renewed emphasis on general "thought-oriented" practice as opposed to specialized "procedure-oriented" medicine. She concludes with a discussion of the proposed Clinton healthcare plan. Though based primarily on newspaper sources and influenced by Kassler's professional biases, Bitter Medicine is an accessible and thought-provoking analysis of an issue of great concern. Public libraries will find her book a useful, though quickly dated, acquisition.
Kathy Arsenault, Univ. of South Florida at St. Petersburg Lib.
Copyright 1994 Reed Business Information, Inc.

About this edition

• Publisher: Birch Lane Pr
• Publication date: 1994
• ISBN 10: 1559722231
• ISBN 13: 9781559722230
• Binding: Hardcover
• Number of pages: 239