Review: An American Sickness

You know by now that I love reading and sharing information that I learn from a good book. Elisabeth Rosenthal‘s An American Sickness: How Healthcare Became Big Business and How You Can Take It Back is truly one of the most interesting books I’ve read all year! Especially now, as Senators discuss repealing and/or amending the Affordable Care Act, read this book!!!

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Rosenthal, a former journalist and physician, begins by thoroughly describing how the medical-industrial complex takes advantage of patients and legal loopholes. She devotes a chapter each to the ills of insurers, hospitals, physicians, pharmaceutical companies, medical device companies, ancillary service providers, billing and coding contractors, medical researchers, conglomerations, and patient complacency. The facts presented are fascinating: for example, “[t]he average hospital cost per day in the United States was $4,300 in 2013,” more than triple “the cost in Australia and about ten times the cost in Spain”!

The concept that irked me the most is “venture philanthropy.” Of it, Rosenthal writes:

The problem is that many charitable foundations no longer see themselves as funders of research for knowledge propelled by donor dollars to cure a disease, but instead as inventors in new treatments.

When insulin was developed in the 1920s, researchers did not stand by patent protection to reap income, but instead shared their knowledge with the community. When the March of Dimes helped fund vaccination research, it did not bill children or their families for inoculation. Now, medical charities are investing money in research. Because any successful discovery will likely result in royalties to the charity shareholder, the charity has no financial incentive to advocate for the cost of that discovery to be accessible to those served by the charity. Talk about conflict of interest!

Rosenthal devotes the second portion of the book to offering both systemic reform, as well as individualized, methods to save money on medical treatment. Again, this section was disturbing, given that neither Republicans nor Democrats are proposing many of the reforms proposed by Rosenthal. Although concepts like tort reform have been initiated in states like Indiana, contemporary federal reform efforts appear completely off the mark.

Last, but most certainly not least, the end of the book contains multiple appendices patients can use to arm themselves in price negotiation. Although options for comparison shopping for medical procedures are limited, Rosenthal provides links to those options that are available. She also includes template letters patients can use when objecting to healthcare charges.

This book contains good stuff, all around. I’ve been bugging my coworkers about it all week long, eager to share stories about how we are all getting ripped off. This book, however, is not a ripoff, but a real gem for the bookshelf!

Review: Life, Liberty & the Defense of Dignity

Leon Kass Life, Liberty & the Defense of Dignity: The Challenge for Bioethics is an oldie, but a goodie. The premier bioethicist explains the philosophy of dignity, and describes how various technological advances, including cloning and progress toward immortality, threaten dignity and humanity itself.

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The book is heavy stuff. In addition to the gravity of the subject matter, Kass dives into Kantian ethics, etymology, and the philosophy of science. Perhaps this will deter the casual reader, but those interested in the subject should appreciate the thorough eloquence of the author.

The main challenges Kass addresses include: the origins of procreation, genetic therapy, cloning, the sale of organs, the so-called “right to die,” the quest for immortality, and the nature of biology. Throughout, Kass argues in favor of restraint and respect for human nature.

I was particularly intrigued by those  passages of the book in which Kass opines on the nature of humanity itself, writing that the corporeal nature of our situation should not be discounted.

The point is crucial, and stands apart from the text that teaches that: everything high about human life – thinking, judging, loving, willing, acting – depends absolutely on everything low – metabolism, digestion, respiration, circulation, excretion. In the case of human beings, “divinity” needs blood – or “mere” life – to sustain itself. And because of what it holds up, human blood – that is, human life – deserves special respect, beyond that which is owed to life as such; the low ceases to be the low.

If the above quote gets you thinking, I highly recommend reading the remainder of Kass’ book! Indeed, given the attention on healthcare as of late, Kass’ theories are all the more timely and deserving of contemplation.

Review: Rising Star

Earlier this week I finally finished David J. Garrow’s Rising Star: The Making of Barack Obama. I say finally for a few reasons. The book is so long – my e-book, in regular typeface, was about 2,000 pages – and so detailed that it reminded me of War and Peace. In fact, the first chapter opens with 1970s Chicago, well before Obama ever set foot there. And it contains so many different characters that it’s difficult to keep everyone straight. Nonetheless, Garrow effectively shows the inner war and peace Obama encountered on his path to the presidency.

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Those who read Obama’s Dreams From My Father are familiar with the gist of Obama’s background. His mother is a white American and his father was a black Kenyan.  Neither parent was physically present for the majority of Obama’s childhood, and he was raised by his maternal grandparents after living with his mother and stepfather for several years in Indonesia. Obama describes himself, in his autobiography, as someone searching for identity and place.

Garrow unravels the vignettes written by Obama, and digs much deeper into Obama’s past.  While many of Obama’s Hawaiian friends from childhood remembered him as a smart and laid-back individual, Obama’s book doesn’t necessarily portray the same, but instead describes racial conflict. Garrow, instead, posits that Obama actually became more aware of racial conflict and identity while at Occidental College.  It was then that Obama ceased allowing friends to call him “Barry,” and became “Barack.” It was then that he chose his identity as black (rather than someone of multiple ethnicities.)

Another fascinating portion of the book follows Obama’s relationship with Sheila Jager. Garrow suggests that Obama ultimately broke up with Jager because Obama believed that he could not successfully run for higher political office unless he developed ties in the African-American community by marrying a woman from the same. Michelle Robinson filled that role perfectly. (And Michelle Obama did all that she could to keep her husband from running for office, believing politics was beneath his talents.)

I would recommend this book to anyone interested in learning more about President Obama, Chicago politics, or campaigning. While the book focuses on both the personal and the political, the personal accounts, gleaned through interviews Obama’s friends and relations, were the most interesting. They provide insight into the motivations of a man that led America for eight years.

Review: In Our Hands

You might’ve heard about political scientist and professor Charles Murray recently. He was the subject of a recent campus protest, and is also (in)famous for writing The Bell Curve. I picked up the most recent draft of his call for the creation of a universal basic income (“UBI”), In Our Hands: A Plan for Replacing the Welfare State.  As a person who relies on government welfare programs (e.g., Medicaid), I’m skeptical of most libertarian plans for reform. However, Murray and his book surprised me in a very positive way!

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Unsurprisingly, Murray calls for the elimination of most wealth transfer programs, including Social Security, Medicare, Medicaid, and additional programs that may not initially come to mind when one thinks about welfare (e.g., farming subsidies). However, people – citizens, at least – will not be left completely without government support. Wealth transfer programs will be replaced by UBI. The figure Murray gives is $13,000 per year for each individual aged 21 and older (the amount can be proportionally reduced by up to $6,500, depending upon how much income a given citizen receives each year). Lest you think this is going to cost taxpayers even more than current welfare programs, Murray’s proposal is actually less costly than the status quo!

Unlike current programs that place in enormous restrictions on how each form of wealth transfer may be used, Murray’s UBI has at least $3,000 each year must be used to purchase catastrophic health insurance. This should please Democrats, in that all Americans would have healthcare. It should also please Republicans, in that catastrophic care truly is health insurance. Believe it or not, I am also impressed by Murray’s proposal because he states that long-term care would be included in the mandatory health insurance packages. People with severe disabilities in need of personal care assistance have been looking for a Medicaid alternative for years – could Murray’s UBI be it?

There is much more to discuss in this short book, and perhaps this blog will revisit some of the other benefits of UBI at a later time. I’m intrigued with the idea, and have been mulling over Murray’s proposal all week. Needless to say, this is definitely a book I recommend to anyone interested in government reform.  AEI-affiliated ideas strike again!

Review: The Death of Expertise

Yesterday I finished Tom Nichols’ quick read, The Death of Expertise. In a nutshell:

Americans have reached a point where ignorance, especially of anything related to public policy, is an actual virtue. To reject the advice of experts is to assert autonomy, a way for Americans to insulate their increasingly fragile egos from ever being told they’re wrong about anything.

Immediately coming to mind after reading that excerpt was images of Sean Hannity and other commentators  railing against “snowflakes,” a pejorative term for millennials that demand “safe spaces” and recognition of their value. In fact, Nichols devotes an entire chapter to higher education, noting that students are increasingly rude to professors, increasingly less deferential now that education has become a business and the customer is always right – even when the customer is clearly, factually, and undeniably incorrect. Most institutions of higher learning now give out As and Bs to 80% of the students in any given class.

Although conservatives are usually quick to point out the disturbing consequences of this failure of higher education, an area dominated by liberal thinkers, Nichols ideologically balanced in his arguments against anti-intellectualism. He blames talk radio hosts like Rush Limbaugh for only featuring single viewpoints, and even screening callers to ensure that there will be no on-air debating. Nichols also targets President Trump, who has promoted misconceptions about vaccination and President Obama’s birth place.

Regardless of who is to blame for the tension between intellectual elites and the larger populace, the mutual contempt could spell disaster for the American republic, which relies on an informed citizenry.  Although Nichols fears that an economic collapse or natural disaster may be necessary to bring these warring groups together, he does provide a roadmap for going forward. Nichols implores the general citizenry to take the time to consider expert opinions, for example, and directs experts not to withdraw into their proverbial ivory towers.

Given that every American bears responsibility to the republic, this book is worth a read.

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Review: Between the World and Me

Ta-Nehisi Coates’ Between the World and Me is quite possibly one of the most demoralizing works I’ve ever read. This feeling is driven home even farther when considering that the book is written as a letter to Coates’ 15-year-old (at the time of its writing) son. Ouch!

I picked up the book for two reasons. First, it’s been on the New York Times Bestseller List for quite a while, and I was sick of looking at it without having read it. Second, I’m always interested in hearing other perspectives, and Coates has a significant reputation as a voice in the black community.

Coates does have an interesting perspective on race. For starters, he writes that “race is a child of racism, not the father.” In other words, race is a classification artificially manufactured by humans, rather than reflecting any meaningful distinctions. Nevertheless, Coates recognizes that black people have formed a community; it is diverse, but black people have come to identify with one another as a result of the oppressive American sorting system.

However, Coates begins to lose me when he begins decrying the education system as a tool of oppression, “a jail of other people’s interests.” To many, including many people with disabilities who have also suffered oppression, education has provided a path to economic freedom and upward mobility. Coates never really answers challenges such as this, except for saying that the individual intentions of educators should be forgotten: “What any institution, or its agents, ‘intend’ for you is secondary.” Later he writes that his “classroom was a jail of other people’s interests.” What a great thing to tell a teenager…

Coates continually engages hypocritical thinking Although he writes that he “raised [his son] to respect every human being has singular,” he refuses to respect individuals, such as the teachers described above or the police officer that shot his friend. Instead, he considers them tools of an oppressive system that cares only about promoting the American Dream. Throughout the book, Coates lovingly discusses past girlfriends, his wife, son is, and friends. But he refuses to grant individual white people the benefit of the doubt or to even view them as individual actors rather than “majoritarian pigs” in some diabolical system of systemic oppression.

Don’t get me wrong – Coates has ample reason to be upset about the way America has treated black people. Beyond slavery and sins of the past, America still makes it difficult for black people to find things like affordable and accessible housing. There are prejudices built into the system. However, unlike Coates, I haven’t given up on trying to improve the system. He tells his son, “Perhaps one person can make a change, but not the kind of change that would raise your body to equality with your countrymen.”  That statement sickens me, as does Coates’ Jeremiah Wright-like reaction to 9/11. I still believe in my country, in all of its people.

Review: Planet of the Blind

In honor of Disability Awareness Month, I decided to read a memoir about disability: Stephen Kuusisto‘s Planet of the Blind. It was a great choice, and I give it two thumbs up.

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As a person with a disability, myself, I’m not a big fan of the disability memoir-genre. Typically, they tend to bemoan lost status (especially those written by authors with spinal cord injuries) or start out from the perspective of wanting to inspire readers. While Kuusisto does expend pages writing of his desire to “pass” in “normal” society, he uses more to show the folly of his attempts. In effect, Planet of the Blind is a story of disability acceptance.

Perhaps what I enjoyed most about Kuusisto’s work is that he is a poet, and his prose is stunning. For example: “My masculinity is fragile, my ego crawls around blindness like a snail exploring a piece of broken glass.” For the most part, readers are free from repeated clichés about overcoming and finding peace; Kuusisto has the vocabulary to invite readers more deeply into his thought processes and emotional responses.

In chart, if you are interested in reading something more than a memoir, consider Planet of the Blind.