Critical Condition: How Health Care In America Became Big Business-And Bad Medicine:

Title: Critical Condition: How Health Care In America Became Big Business-And Bad Medicine:

Authors: Donald L. Barlett and James B. Steele

ISBN: 038550453

The following review was contributed by:NORM GOLDMAN: Editor of Bookpleasures:


Investigative reporters and the only journalists in history to be awarded two Pulitzer Prizes and two National Magazine Awards, Donald L. Barlett and James B. Steele have presented a riveting exposť of the critical state of the health system in the United States with their book Critical Condition: How Health Care In America Became Big Business-And Bad Medicine.

Beginning with the assertion that American health care has been transposed from one of compassion to a system motivated by profit- the authors present a distressing analysis as to what went wrong. Where forty-four million citizens do not have health insurance, and tens of millions more are underinsured. And yet there seems to be this enduring myth propagated by many that the USA has a "world- class health system."

As mentioned by the authors, the USA spends more on health care than any other nation, when you compare it to Germany, France, Japan, Italy, and Canada. However, in these countries citizens do not think twice about seeking care if they are ill. They do not worry who will foot the bills.

In the USA, it has become a lottery. If you are fortunate to be employed by a large company providing generous health benefits, you win. On the other hand, if you are self-employed or work for a small enterprise providing little or no coverage, you lose. You may even go bankrupt and lose your home in order to pay your medical bills.

Relying on interviews, studies from various organizations as the World Health Organization, the US department of Health and Human Services, legal suits, brokerage reports, congressional hearings, newspaper articles, magazine stories, SEC filings, professional journals, and a resevoir of many other sources (all of which are mentioned in the Notes section at the back of the book), the authors deliver legitimate arguments illustrating how an assortment of factors have crawled into the system with calamitous effects.

Broken down into six chapters, Barlett and Steele judiciously examine some of these elements as: rampant overcharging of patients who do not have insurance, dissuading people from purchasing drugs from Canada with false information concerning the Canadian pharmaceutical industry, caving into the demands of special interest groups, the non-existence of independent monitoring of diagnostic test results and hospital mistakes, permitting politicians and business people to assume key roles to the detriment of the welfare of the citizens, a culture of cronyism giving rise to blatant fraud in many instances, doctors having to deal with conditions apt to be found in undeveloped countries, peopled shuffled around by individuals who do not have the foggiest notion as to how to deal with them.

In addition, we are informed of how private enterprises connected with Wall Street financiers and Madison Avenue advertising firms have been permitted to join in as if health care was analogous to the selling of cars or MacDonald's franchises. As the authors rightfully ask: "Is this what health care in America has become?"

Although the authors portray a certain amount of cynicism, there is a glimmer of hope, as evidenced by the concluding chapter, wherein suggestions are offered as to how to revamp the ailing system.

However, the question lingers on. Will Americans reconsider their values, priorities, budgets and options and elect people, who will first and foremost take care of its citizens when it comes to health care? Something most civilized nations do.

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Poetry: Layli Long Soldier, Whereas (Graywolf)

Criticism: Carina Chocano, You Play The Girl: On Playboy Bunnies, Stepford Wives, Trainwrecks, & Other Mixed Messages (Mariner)

Autobiography: Xiaolu Guo, Nine Continents: A Memoir In and Out of China (Grove)

Biography: Caroline Fraser, Prairie Fires: The American Dreams of Laura Ingalls Wilder (Metropolitan Books)

Nonfiction: Frances FitzGerald, The Evangelicals: The Struggle to Shape America (Simon & Schuster)

Fiction: Joan Silber, Improvement (Counterpoint)

The John Leonard Prize: Carmen Maria Machado, Her Body and Other Parties (Graywolf)

The Nona Balakian Citation for Excellence in Reviewing: Charles Finch

The Ivan Sandrof Lifetime Achievement Award: John McPhee

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