An indignant, urgent indictment of the for-profit American way of medical care.
A dispiriting look at the replacement of the Hippocratic oath by a PIN number that centers on the big business of kidney dialysis.
Basing his account on interviews with hundreds of constituents of the “dialysis community,” journalist Mueller, author of Extra Virginity and Crisis of Conscience, describes a health care industry that is seemingly entirely focused on profit. Most dialysis takes place at clinics where a premium is placed on getting patients in and out quickly, with the withdrawal and reinsertion of blood occurring more rapidly than the body can comfortably accommodate—even though in many instances, “when administered this way, dialysis may shorten patients’ lives by stripping off bodily fluids too fast, triggering sudden drops in blood pressure that can damage the heart, brain, gut, and lungs and lead to stroke, congestive heart failure, and cardiac arrest.” If you complain, you’re likely to be denied care—and, worse, far too many nephrologists are disinclined to fight on behalf of their patients. One nephrologist recounts that a colleague told her he had developed “techniques for goading undesirable patients into acting out, in order to eject them from his facility.” Most of these patients are insured by Medicare or Medicaid, a system that pays less than private insurance. Against the American system of “bazooka dialysis,” most advanced countries use a slower, more frequent program of dialysis. Furthermore, many of them place the locus of dialysis at home, with patients self-administering their care, a method that the American medical system lobbied hard to discourage. Some American physicians are bucking the system, Mueller writes, and the Trump administration issued an executive order demanding improved care—likely only because, Mueller ventures, Health and Human Services Secretary Alex Azar’s father “had been on dialysis for several years.” Even so, the system remains a mess, and bad actors are seldom punished.
An indignant, urgent indictment of the for-profit American way of medical care.Pub Date: Aug. 1, 2023
ISBN: 9780393866513
Page Count: 288
Publisher: Norton
Review Posted Online: June 28, 2023
Kirkus Reviews Issue: Aug. 1, 2023
BOOK REVIEW
BOOK REVIEW
Cogent, well-timed ideas for meeting today’s biggest challenges.
Helping liberals get out of their own way.
Klein, a New York Times columnist, and Thompson, an Atlantic staffer, lean to the left, but they aren’t interrogating the usual suspects. Aware that many conservatives have no interest in their opinions, the authors target their own side’s “pathologies.” Why do red states greenlight the kind of renewable energy projects that often languish in blue states? Why does liberal California have the nation’s most severe homelessness and housing affordability crises? One big reason: Liberal leadership has ensnared itself in a web of well-intentioned yet often onerous “goals, standards, and rules.” This “procedural kludge,” partially shaped by lawyers who pioneered a “democracy by lawsuit” strategy in the 1960s, threatens to stymie key breakthroughs. Consider the anti-pollution laws passed after World War II. In the decades since, homeowners’ groups in liberal locales have cited such statutes in lawsuits meant to stop new affordable housing. Today, these laws “block the clean energy projects” required to tackle climate change. Nuclear energy is “inarguably safer” than the fossil fuel variety, but because Washington doesn’t always “properly weigh risk,” it almost never builds new reactors. Meanwhile, technologies that may cure disease or slash the carbon footprint of cement production benefit from government support, but too often the grant process “rewards caution and punishes outsider thinking.” The authors call this style of governing “everything-bagel liberalism,” so named because of its many government mandates. Instead, they envision “a politics of abundance” that would remake travel, work, and health. This won’t happen without “changing the processes that make building and inventing so hard.” It’s time, then, to scrutinize everything from municipal zoning regulations to the paperwork requirements for scientists getting federal funding. The authors’ debut as a duo is very smart and eminently useful.
Cogent, well-timed ideas for meeting today’s biggest challenges.Pub Date: March 18, 2025
ISBN: 9781668023488
Page Count: 320
Publisher: Avid Reader Press
Review Posted Online: Jan. 16, 2025
Kirkus Reviews Issue: Feb. 15, 2025
BOOK REVIEW
PERSPECTIVES
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our...
A psychologist and Nobel Prize winner summarizes and synthesizes the recent decades of research on intuition and systematic thinking.
The author of several scholarly texts, Kahneman (Emeritus Psychology and Public Affairs/Princeton Univ.) now offers general readers not just the findings of psychological research but also a better understanding of how research questions arise and how scholars systematically frame and answer them. He begins with the distinction between System 1 and System 2 mental operations, the former referring to quick, automatic thought, the latter to more effortful, overt thinking. We rely heavily, writes, on System 1, resorting to the higher-energy System 2 only when we need or want to. Kahneman continually refers to System 2 as “lazy”: We don’t want to think rigorously about something. The author then explores the nuances of our two-system minds, showing how they perform in various situations. Psychological experiments have repeatedly revealed that our intuitions are generally wrong, that our assessments are based on biases and that our System 1 hates doubt and despises ambiguity. Kahneman largely avoids jargon; when he does use some (“heuristics,” for example), he argues that such terms really ought to join our everyday vocabulary. He reviews many fundamental concepts in psychology and statistics (regression to the mean, the narrative fallacy, the optimistic bias), showing how they relate to his overall concerns about how we think and why we make the decisions that we do. Some of the later chapters (dealing with risk-taking and statistics and probabilities) are denser than others (some readers may resent such demands on System 2!), but the passages that deal with the economic and political implications of the research are gripping.
Striking research showing the immense complexity of ordinary thought and revealing the identities of the gatekeepers in our minds.Pub Date: Nov. 1, 2011
ISBN: 978-0-374-27563-1
Page Count: 512
Publisher: Farrar, Straus and Giroux
Review Posted Online: Sept. 3, 2011
Kirkus Reviews Issue: Sept. 15, 2011
BOOK REVIEW
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