Wednesday, September 11, 2013


The author, a former medical director, uses 12 patients (he's one of them; he was diagnosed with cancer and underwent chemo and radiation) as "windows" into 12 different systemic and ethical problems--illegal immigration, the foster care system, alcoholism, compliance, organ donation, etc. The writing is uneven at times; he ostensibly quotes patients, but their voices sound surprisingly like his own; and sometimes stories/chapters end with a strange abruptness. But I like this sort of book for the way it broaches topics and doesn't present pat, black-and-white answers. It serves as an invitation for people to think about complicated issues; and it shows just how many facets of our society are linked with healthcare. Some of my favorite lines: "How people die and how we participate in their deaths is as much about us as about them. Our own humanity is at stake. In a society that is increasingly mesmerized by efficiency, measurement by numbers and a bottom-line mentality that extols profit and wealth over any other human value, the risk is clear to everyone I work with. When health care is now measured by a 'medical loss ratio,' and the percentage of spending on health care is considered a 'loss,' then we are really lost."

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