Monday 30 November 2015

American Federalism in Practice: The Formulation and Implementation of Contemporary Health Policy

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American Federalism in Practice is an original and important contribution to our understanding of contemporary health policy. It also illustrates how contentious public policy is debated, formulated, and implemented in today's overheated political environment.

Health care reform is perhaps the most divisive public policy issue facing the United States today. Michael Doonan provides a unique perspective on health policy in explaining how intergovernmental relations shape public policy. He tracks federal-state relations through the creation, formulation, and implementation of three of the most important health policy initiatives since the Great Society: the State Children's Health Insurance Program (CHIP) and the Health Insurance Portability and Accountability Act (HIPAA), both passed by the U.S. Congress, and the Massachusetts health care reform program as it was developed and implemented under federal government waiver authority. He applies lessons learned from these cases to implementation of the Affordable Care Act.

"Health policymaking is entangled in a complex web of shared, overlapping, and/or competing power relationships among different levels of government," the author notes. Understanding federal-state interactions, the ways in which they vary, and the reasons for such variation is essential to grasping the ultimate impact of federalism on programs and policy. Doonan reveals how federalism can shift as the sausage of public policy is made while providing a new framework for comprehending one of the most polarizing debates of our time.

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Friday 27 November 2015

The Ecology of Care: Medicine, Agriculture, Money, and the Quiet Power of Human and Microbial Communities

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What can Cuban doctors, innovative ranchers in Saskatchewan, and the microbiome teach us about how to care for people and the Earth at the same time?
In this richly layered book, Didi Pershouse takes us on a fast-moving, sharp-witted journey through her own life: from growing up with the neurosurgeon who accidentally discovered the seat of memory in the brain, to working in a smoke-filled office at New York magazine, to her career as an innovative acupuncturist in Vermont, and on to a passion for close-knit communities, grazing cows, and soil restoration as solutions to much of what ails us. Along the way, she unfolds a surprising new take on the story of our time: how the germ theory of disease joined with a profit-based economy, and unwittingly led to a “sterilization” of medicine, agriculture, and even our social lives. This 150-year detour has brought about the near destruction of our climate as well as a great forgetting of the power of connection. By documenting a scientific understanding of the intelligence of the whole, Pershouse nudges us awake with a hopeful view and shows us how to reclaim the rich, “fertile” lives we are meant for..


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Remedy and Reaction: The Peculiar American Struggle over Health Care Reform, Revised Edition

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In no other country has health care served as such a volatile flashpoint of ideological conflict. America has endured a century of rancorous debate on health insurance, and despite the passage of the Affordable Care Act in 2010, the battle is not yet over. This book is a history of how and why the United States became so stubbornly different in health care, presented by an expert with unsurpassed knowledge of the issues..

Tracing health-care reform from its beginnings to its current uncertain prospects, Paul Starr argues that the United States ensnared itself in a trap through policies that satisfied enough of the public and so enriched the health-care industry as to make the system difficult to change.

He reveals the inside story of the rise and fall of the Clinton health plan in the early 1990s—and of the Gingrich counterrevolution that followed. And he explains the curious tale of how Mitt Romney’s reforms in Massachusetts became a model for Democrats and then follows both the passage of those reforms under Obama and the explosive reaction they elicited from conservatives. Writing concisely and with an even hand, the author offers exactly what is needed as the debate continues—a penetrating account of how health care became such treacherous terrain in American politics.

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America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System

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America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System Info

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NEW YORK TIMES BESTSELLER • A NEW YORK TIMES NOTABLE BOOK • America’s Bitter Pill is Steven Brill’s acclaimed book on how the Affordable Care Act, or Obamacare, was written, how it is being implemented, and, most important, how it is changing—and failing to change—the rampant abuses in the healthcare industry. It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation.
 
But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury.
 
Praise for America’s Bitter Pill
 
“A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”The New York Times
 
“An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.”—The New York Times Book Review
 
“A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”Los Angeles Times
 
“A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”The Daily Beast
 
“One of the most important books of our time.”—Walter Isaacson
 
“Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”The New York Review of Books


From the Hardcover edition..


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Wednesday 25 November 2015

Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System

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Reinventing American Health Care: How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System Description

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In March 2010 the Affordable Care Act was signed into law. It was the most extensive reform of America's health-care system since at least the creation of Medicare in 1965 and maybe ever. The ACA was controversial and highly political, and the law faced legal challenges reaching all the way to the Supreme Court; it even precipitated a government shutdown.

Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania who also served as a special adviser to the White House on health-care reform, has written a brilliant diagnostic explanation of why health care in America has become such a divisive social issue, how money and medicine have their own American story, and why reform has bedeviled presidents of the left and right for more than one hundred years.

Emanuel also explains exactly how the ACA reforms are reshaping the health-care system now. He forecasts the future, identifying six megatrends in health that will determine the market for health care to 2020 and beyond. His predictions are bold, provocative, and uniquely well informed. Health care has never had a more comprehensive or authoritative interpreter.

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Monday 23 November 2015

Dying Well: Peace and Possibilities at the End of Life

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Dying Well: Peace and Possibilities at the End of Life La revue

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From Ira Byock, prominent palliative care physician and expert in end of life decisions, a lesson in Dying Well.

Nobody should have to die in pain. Nobody should have to die alone.


This is Ira Byock's dream, and he is dedicating his life to making it come true. Dying Well brings us to the homes and bedsides of families with whom Dr. Byock has worked, telling stories of love and reconciliation in the face of tragedy, pain, medical drama, and conflict. Through the true stories of patients, he shows us that a lot of important emotional work can be accomplished in the final months, weeks, and even days of life. It is a companion for families, showing them how to deal with doctors, how to talk to loved ones—and how to make the end of life as meaningful and enriching as the beginning.

Ira Byock is also the author of The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life.On his deathbed, faced with creditors and unpaid bills, Oscar Wilde said despairingly, "I am dying beyond my means!" If only the poor, beleaguered genius had read this book! None of us gets out of here alive, but reading this book will lessen your fear of the ultimate end and give you some guidance about enjoying your life to the fullest right up until your final moment. Do people really enjoy life in the face of death? People do. The stories of individuals in Dr. Byock's book will move and inspire you to change your feelings about the end of your life, and also your feelings about your life in the present..


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Saturday 21 November 2015

Improvising Medicine: An African Oncology Ward in an Emerging Cancer Epidemic

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In Improvising Medicine, Julie Livingston tells the story of Botswana's only dedicated cancer ward, located in its capital city of Gaborone. This affecting ethnography follows patients, their relatives, and ward staff as a cancer epidemic emerged in Botswana. The epidemic is part of an ongoing surge in cancers across the global south; the stories of Botswana's oncology ward dramatize the human stakes and intellectual and institutional challenges of an epidemic that will shape the future of global health. They convey the contingencies of high-tech medicine in a hospital where vital machines are often broken, drugs go in and out of stock, and bed-space is always at a premium. They also reveal cancer as something that happens between people. Serious illness, care, pain, disfigurement, and even death emerge as deeply social experiences. Livingston describes the cancer ward in terms of the bureaucracy, vulnerability, power, biomedical science, mortality, and hope that shape contemporary experience in southern Africa. Her ethnography is a profound reflection on the social orchestration of hope and futility in an African hospital, the politics and economics of healthcare in Africa, and palliation and disfigurement across the global south.
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The Cultural Context of Health, Illness, and Medicine, 2nd Edition

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A "one size fits all" approach to health care doesn't work well, especially for America's extremely diverse population. This book provides a lively and accessible discussion of how and why a more flexible and culturally sensitive system of health care can―and must be―achieved.


• More than 30 percent new material updates the 1997 edition, reflecting new scholarship and addressing emerging needs

• Multiple real-life examples and case studies illustrate and explain concepts

• Discussion questions follow each chapter and an appendix with project suggestions is provided

• A bibliography offers suggestions for further reading

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Friday 20 November 2015

The Conversation: A Revolutionary Plan for End-of-Life Care

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Despite billions of dollars invested in medical research and technological breakthroughs in American healthcare made to prolong and improve the lives of patients, a devastating statistic remains. Two thirds of Americans die in healthcare institutions tethered to machines and tubes at bankrupting costs, despite research that shows 80 percent of Americans would prefer to spend their last days in their homes surrounded by loved ones.

Dr. Angelo E. Volandes, a physician at Harvard Medical School and Massachusetts General Hospital, has witnessed far too often the unnecessary suffering patients and their families face when confronted with difficult end-of-life decisions. The solution, he knows, is not the latest technology. The most effective, powerful, and empathetic tool a doctor can offer is perhaps the simplest: The Conversation.

In his groundbreaking new book, Volandes illustrates how initiating an honest discussion among doctors, patients, and their families will empower patients to establish the treatment goals they want while avoiding procedures that cause more harm than good, thus closing the enormous gap between the care people want at the end of life and the care they actually receive.

With wisdom and compassion, Volandes not only recounts the compelling stories of seven patients confronting different end-of-life experiences, but also provides invaluable information-from helpful language to address family members and physicians to instructions for navigating advance directives. He delivers important lessons and indispensable resources-including an online video.

As a physician and patients' rights advocate, Volandes has dedicated his life to establishing a new standard of care. The Conversation is the essential guide that has long been missing from American medicine. It will embolden patients and inspire doctors to advocate for the choices that promote peace of mind and improve quality of life, because a life well lived deserves a good ending.

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Wednesday 18 November 2015

The Healing of America: A Global Quest for Better, Cheaper, and Fairer Health Care

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Bestselling author T. R. Reid guides a whirlwind tour of successful health care systems worldwide, revealing possible paths toward U.S. reform.

In The Healing of America, New York Times bestselling author T. R. Reid shows how all the other industrialized democracies have achieved something the United States can’t seem to do: provide health care for everybody at a reasonable cost.

In his global quest to find a possible prescription, Reid visits wealthy, free market, industrialized democracies like our own—including France, Germany, Japan, the U.K., and Canada—where he finds inspiration in example. Reid shares evidence from doctors, government officials, health care experts, and patients the world over, finding that foreign health care systems give everybody quality care at an affordable cost. And that dreaded monster “socialized medicine” turns out to be a myth. Many developed countries provide universal coverage with private doctors, private hospitals, and private insurance.

In addition to long-established systems, Reid also studies countries that have carried out major health care reform. The first question facing these countries—and the United States, for that matter—is an ethical issue: Is health care a human right? Most countries have already answered with a resolute yes, leaving the United States in the murky moral backwater with nations we typically think of as far less just than our own.

The Healing of America lays bare the moral question at the heart of our troubled system, dissecting the misleading rhetoric surrounding the health care debate. Reid sees problems elsewhere, too: He finds poorly paid doctors in Japan, endless lines in Canada, mistreated patients in Britain, spartan facilities in France. Still, all the other rich countries operate at a lower cost, produce better health statistics, and cover everybody. In the end, The Healing of America is a good news book: It finds models around the world that Americans can borrow to guarantee health care for everybody who needs it..


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The Cleveland Clinic Way: Lessons in Excellence from One of the World's Leading Health Care Organizations VIDEO ENHANCED EBOOK: Lessons in Excellence from ... Care Organizations VIDEO ENHANCED EBOOK

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This is the future. Join the revolution. Transform your organization the Cleveland Clinic way.

American healthcare is in crisis. It doesn't have to be.The Cleveland Clinic Way is a blueprint for fixing what's wrong with healthcare—and is a must-read for every leader seeking to transform his or her organization.

There's a revolution going on right now. On the frontiers of medicine, some doctors have developed an approach for treating people that is more effective, more humane, and more affordable. It's an approach to healthcare that has captured the attention of the media and business elite--and the President of the United States.

It's all happening at Cleveland Clinic, one of the most innovative, forward-looking medical institutions in the nation.

In this groundbreaking book, the man who leads this global organization, Toby Cosgrove, MD, reveals how the Clinic works so well and argues persuasively for why it should be the model for the nation. He details how Cleveland Clinic focuses on the eight key trends that are shaping the future of medicine. Readers will learn:

  • Why group practices provide not only better--but cheaper--care
  • Why collaborative medicine is more effective
  • How big data can be harnessed to improve the quality of care and lower costs
  • How cooperative practices can be the wellspring of innovation
  • Why empathy is crucial to better patient outcomes
  • Why wellness of both mind and body depends on healthcare, not sickcare
  • How care is best provided in different settings for greater comfort and value
  • How tailor-made care treats a person instead of a disease

At its core is Cleveland Clinic's emphasis on patient care and patient experience.

A refreshingly positive and practical vision of healthcare, The Cleveland Clinic Way is essential reading for healthcare and business executives, medical professionals, industry analysts, and policymakers. It gives leaders lessons they can apply to their own organizations to achieve results and empowers average Americans to make more informed healthcare decisions.

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Monday 16 November 2015

Prescription for a Healthy Nation: A New Approach to Improving Our Lives by Fixing Our Everyday World

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America spends more than twice as much for health care as any other nation. So why are Americans among the sickest people in the industrialized world?

Public health experts Tom Farley and Deborah A. Cohen show that the answer does not lie in our medical care system but rather in the world around us. As they explain, the leading killers of our time fall almost entirely into two categories: injuries and chronic diseases such as heart disease, lung and breast cancer, diabetes, and stroke. For all its inspiring, high-tech cures, modern medicine is just not very effective at combating these illnesses. Our health, as Farley and Cohen explain, depends much less on medicine than on how we lead our lives. And as their surprising and illuminating examples show, our behavior and our health are in fact shaped by our everyday world-from the design of our cities to the rules that govern our organizations.

Obesity, for example, has emerged as a major health threat because our environment makes it difficult to be physically active and because prepared high-calorie foods-from chips and candy bars to fast food and "food on the go"-saturate our surroundings. Though we'd like to believe that we could stay slim through individual self-discipline, our everyday world overwhelms our resolve. In similar ways, the world around us influences whether we live our lives in ways that increase or decrease our chances of dying from killers as wide-ranging as cancer and car crashes.

In the last part of the book, Farley and Cohen remind us of once-controversial changes to our physical environment that have saved tens of thousands of lives and outline many other ways in which we can change our daily environment so we can all live longer and healthier.

Prescription for a Healthy Nation is at once an exposé of how various industries influence our health for the worse, a paradigm-shifting argument about health and disease, and a positive blueprint for how to create a healthier society.


From the Hardcover edition.America spends more than twice as much for health care as any other nation. So why are Americans among the sickest people in the industrialized world?

Public health experts Tom Farley and Deborah A. Cohen show that the answer does not lie in our medical care system but rather in the world around us. As they explain, the leading killers of our time fall almost entirely into two categories: injuries and chronic diseases such as heart disease, lung and breast cancer, diabetes, and stroke. For all its inspiring, high-tech cures, modern medicine is just not very effective at combating these illnesses. Our health, as Farley and Cohen explain, depends much less on medicine than on how we lead our lives. And as their surprising and illuminating examples show, our behavior and our health are in fact shaped by our everyday world-from the design of our cities to the rules that govern our organizations.

Obesity, for example, has emerged as a major health threat because our environment makes it difficult to be physically active and because prepared high-calorie foods-from chips and candy bars to fast food and "food on the go"-saturate our surroundings. Though we'd like to believe that we could stay slim through individual self-discipline, our everyday world overwhelms our resolve. In similar ways, the world around us influences whether we live our lives in ways that increase or decrease our chances of dying from killers as wide-ranging as cancer and car crashes.

In the last part of the book, Farley and Cohen remind us of once-controversial changes to our physical environment that have saved tens of thousands of lives and outline many other ways in which we can change our daily environment so we can all live longer and healthier.

Prescription for a Healthy Nation is at once an exposé of how various industries influence our health for the worse, a paradigm-shifting argument about health and disease, and a positive blueprint for how to create a healthier society.


From the Hardcover edition..


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Reviving America: How Repealing Obamacare, Replacing the Tax Code and Reforming The Fed will Restore Hope and Prosperity

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Conservative icon Steve Forbes returns with his most powerful and provocative ideas yet

The United States has been through one of the most tumultuous decades in recent history. Polls show people on both sides of the ideological divide believe that the country has gone off track. If something isn’t done quickly, Americans face a bleak future—continuing decline and disarray in a world that grows ever more dangerous.

Steve Forbes, two-time candidate for the GOP presidential nomination and Forbes Media Chairman, explains how today’s malaise has been caused by years of Obama’s destructive policies, a broken tax system, and the Federal Reserve’s Soviet-style controls over credit and money.

The problems are challenging. But Forbes tells us that, with the right policies, the country can bounce back faster than people think. In this compelling and much-needed book, he sets forth a three-part plan to revive America.

Patient-Driven Healthcare: The problem with healthcare, Forbes says, is that Big Government, health insurance companies, and employers are in control, not you, the patient. The key to getting high-quality, affordable healthcare is increasing competition and choice, and putting patients in charge.

Enact a Flat Tax: Today’s complex, corrupt tax code must be scrapped. The best answer is a simple Flat Tax. Forbes shows how this very bold reform would free America from the IRS and unleash an unprecedented wave of prosperity.

A Sound Dollar as Good as Gold: With its ever-fluctuating “fiat” dollar, the Federal Reserve has blocked a real recovery and is the prime cause of today’s stagnant, crisis-ridden economy. The answer? Take the dollar out of the hands of the Washington politicians by returning to a monetary system with the value of the dollar linked to gold.

A clear and vital guide, Reviving America shows how the United States can recover the optimism and entrepreneurial dynamism that made it the greatest nation in history. These are 21st century solutions—not the failed ideas of the recent past. Forbes offers specific ideas and plans, not generalities and bromides, and is challenging policy makers to do the same.

Steve Forbes is the coauthor of Money, the New York Times bestseller Power Ambition Glory, and the Wall Street Journal bestseller How Capitalism Will Save Us. Forbes is the Chairman and Editor-in-Chief of Forbes Media, which published Forbes magazine, with a circulation of nearly 1 million readers. Combined with Forbes Asia and Forbes Europe, and the company's licensee editions, the magazine reaches close to 6 million global readers. Forbes.com reaches almost 70 million unique monthly visitors.

Elizabeth Ames has co-authored three previous books with Steve Forbes: Money: How The Destruction of the Dollar Threatens The Global Economy—And What We Can Do About It; Freedom Manifesto: Why Free Markets Are Moral and Big Government Isn’t; and the Wall Street Journal bestseller, How Capitalism Will Save Us: Why Free People and Free Markets Are The Best Answer In Today’s Economy.

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Sunday 15 November 2015

Healthcare Strategic Planning (Ache Management)

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Strategic planning is an important management tool, especially in an era of uncertainty. A sound strategic plan helps healthcare organizations thrive in dynamic environments and adapt as market conditions change.

This new edition of Healthcare Strategic Planning provides the reader with practical guidance and expert insights for addressing near-term pressures, achieving long-term goals, and managing pitfalls that can derail effective planning.

Descriptions, examples, and guidelines lead the reader step-by-step through a proven strategic planning process.

Strategic planning in the healthcare environment has evolved since the previous editions of this book were published. This edition reinvigorates the discussion with many new ideas and additional information on contemporary strategic planning.

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Friday 13 November 2015

Unhealthy Health Policy: A Critical Anthropological Examination

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This new collection turns a critical anthropological eye on the nature of health policy internationally. The authors reveal that in light of prevailing social inequalities, health policies may intend to protect public health, but in fact they often represent significant structural threats to the health and well being of the poor, ethnic minorities, women, and other subordinate groups. The volume focuses on the 'anthropology of policy,' which is concerned with the process of decision-making, the influences on decision-makers, and the impact of policy on human lives. This collaboration will be a critical resource for researchers and practitioners in medical anthropology, applied anthropology, medical sociology, minority issues, public policy, and health care issues..


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Tuesday 10 November 2015

Tapping into The Wire: The Real Urban Crisis

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Did Omar Little die of lead poisoning? Would a decriminalization strategy like the one in Hamsterdam end the War on Drugs? What will it take to save neglected kids like Wallace and Dukie? Tapping into 'The Wire' uses the acclaimed television series as a road map for exploring connections between inner-city poverty and drug-related violence. Past Baltimore City health commissioner Peter Beilenson teams up with former Baltimore Sun reporter Patrick A. McGuire to deliver a compelling, highly readable examination of urban policy and public health issues affecting cities across the nation. Each chapter recounts scenes from episodes of the HBO series, placing the characters' challenges into the broader context of public policy.

A candid interview with the show’s co-creator David Simon reveals that one of the intentions of the series is to expose gross failures of public institutions, including criminal justice, education, labor, the news media, and city government. Even if readers haven’t seen the series, the book’s detailed summaries of scenes and characters brings them up to speed and engages them in both the story and the issues. With a firm grasp on the hard truths of real-world problems, Tapping into 'The Wire' helps undo misconceptions and encourage a dialogue of understanding.

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Saturday 7 November 2015

The Food Police: A Well-Fed Manifesto About the Politics of Your Plate

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A rollicking indictment of the liberal elite's hypocrisy when it comes to food.

Ban trans-fats? Outlaw Happy Meals? Tax Twinkies? What's next? Affirmative action for cows?   
     A catastrophe is looming. Farmers are raping the land and torturing animals. Food is riddled with deadly pesticides, hormones and foreign DNA. Corporate farms are wallowing in government subsidies. Meat packers and fast food restaurants are exploiting workers and tainting the food supply. And Paula Deen has diabetes!
     Something must be done. So says an emerging elite in this country who think they know exactly what we should grow, cook and eat. They are the food police.
     Taking on the commandments and condescension the likes of Michael Pollan, Alice Waters, and Mark Bittman, The Food Police casts long overdue skepticism on fascist food snobbery, debunking the myths propagated by the food elite.  You'll learn:
-   Organic food is not necessarily healthier or tastier (and is certainly more expensive).
-   Genetically modified foods haven't sickened a single person but they have made farmers more profitable  and they do hold the promise of feeding impoverished Africans.
-   Farm policies aren't making us fat.
-   Voguish locavorism is not greener or better for the economy.
-   Fat taxes won't slim our waists and "fixing" school lunch programs won't make our kids any smarter.
-   Why the food police hypocritically believe an iPad is a technological marvel but food technology is an industrial evil
So before Big Brother and Animal Farm merge into a socialist nightmare, read The Food Police and let us as Americans celebrate what is good about our food system and take back our forks and foie gras before it's too late!

Amazon Q&A with Jayson Lusk

Jayson Lusk

Q. In your book, you really pull the lid off of the hypocrisy surrounding “the food police” and the crusade against big food companies. Why?

A. Two reasons. The first is that, having grown up around many people involved in agricultural and food production, it was time to set the record straight, and to reveal that these folks are neither stupid nor sinister but rather care passionately about their land, their children, and the foods they make. Secondly, it was becoming apparent that the policies proffered by the food police were largely based on ideological agenda rather than empirical evidence that they’d actually work; rather, the evidence is that the implementation of those policies would harm the very people the food police purport to help.

Q. Do you think salt, sugar, and fat are really addictive? If so, can the “fat taxes” really save us?

A. Eating salt, sugar, and fat are enjoyable. Thus it shouldn’t be surprising that the reward centers of our brain get fired up when we eat them. The argument that these ingredients are addictive teeters on calling anything pleasurable addictive. Calling salt, sugar, and fat addictive is stretching the science to fit an agenda.

The economic research on “fat taxes” shows that the policy will have only trivial effects on weight. Adding a new tax is akin to lowering someone’s income, and few of us are happier with less money. The logic that “fat taxes” will actually help the people who are supposed to be helped is untenable.

Q. In your book, you discuss the importance of us consumers making our own choices. Are we as consumers really so weak as to succumb to the whims of Big Food and their flavor construction, marketing, and placement at the grocery store or deli?

A. There is schizophrenic paternalism that results from an awkward attempt to walk a fine line between a liberal agenda that yields to freedom of choice and expression when it comes to abortion, sex, speech, and drugs but stops short when those same freedoms might benefit evil corporations like Big Food. It is an odd position that posits us so weak as to fall for anything offered by Ronald McDonald or Tony the Tiger yet so strong as to know when to keep a baby alive or which truths to speak to power.

It is true, of course, that we are affected by advertising. However, much of the research shows that advertising is primarily used to persuade consumers to switch brands (rather than buy more). The truth is that Big Food can’t force us to buy anything, and they constantly scurry to meet our every whim.

Q. Are organic or locally grown foods actually better for you?

A. By and large, the answer is no. Numerous scientific studies have shown that the nutritional content of organic is essentially equivalent to conventional. Furthermore, it is a complete misnomer that organics are pesticide-free. Organic producers do use “natural” pesticides, many of which are more toxic than “synthetic” pesticides used on conventional farms. You have to remember that organics are much more expensive than the conventional, and if the choice is between eating fewer organic veggies (because they are more expensive) or more conventional veggies (because they are cheaper), the healthier choice is probably to go with the conventional. Local is a whole other issue, which I unpack in the book. You can eat unhealthy local food or healthy foreign food. One has nothing to do with the other.

Q. Are you concerned with the rise in obesity in America? What are some things that you think can improve this issue?

A. I think a better question is: what should the government do about your weight? That is a much more uncomfortable question but it is the better question to ask. There are a lot of personal incentives to reduce weight. The evidence suggests that people with very high levels of obesity earn lower wages, die sooner, have higher medical costs, and face a lot of social scorn. So, the question isn’t whether I’m concerned about obesity but rather whether the obese are concerned about it themselves.

The good news is that the upward trend in obesity is beginning to level off, and among some groups, has actually begun to decline in recent years. It is important to keep in mind the reasons why we experienced a rise in obesity in the first place, and many of those reasons—from less strenuous jobs to more convenient foods to more air-conditioned offices to less expensive food to the development of microwaves and dishwashers—are cause for rejoicing rather than dismay. That doesn’t mean we can look for ways to have our cake and eat it, too, only that we shouldn’t forget how we got the cake.

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Friday 6 November 2015

Patient Safety: A Human Factors Approach

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Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to patients are many and diverse, and the complexity of the healthcare system that delivers them is huge. Yet the discourse is often oversimplified and underdeveloped. Written from a scientific, human factors perspective, Patient Safety: A Human Factors Approach delineates a method that can enlighten and clarify this discourse as well as put us on a better path to correcting the issues.

People often think, understandably, that safety lies mainly in the hands through which care ultimately flows to the patient―those who are closest to the patient, whose decisions can mean the difference between life and death, between health and morbidity. The human factors approach refuses to lay the responsibility for safety and risk solely at the feet of people at the sharp end. That is where we should intervene to make things safer, to tighten practice, to focus attention, to remind people to be careful, to impose rules and guidelines. The book defines an approach that looks relentlessly for sources of safety and risk everywhere in the system―the designs of devices; the teamwork and coordination between different practitioners; their communication across hierarchical and gender boundaries; the cognitive processes of individuals; the organization that surrounds, constrains, and empowers them; the economic and human resources offered; the technology available; the political landscape; and even the culture of the place.

The breadth of the human factors approach is itself testimony to the realization that there are no easy answers or silver bullets for resolving the issues in patient safety. A user-friendly introduction to the approach, this book takes the complexity of health care seriously and doesn’t over simplify the problem. It demonstrates what the approach does do, that is offer the substance and guidance to consider the issues in all their nuance and complexity.

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Thursday 5 November 2015

Public Health Law and Ethics: A Reader (California/Milbank Books on Health and the Public)

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Public Health Law and Ethics: A Reader (California/Milbank Books on Health and the Public) Description

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Now revised and expanded to cover today’s most pressing health threats, Public Health Law and Ethics probes the legal and ethical issues at the heart of public health through an incisive selection of government reports, scholarly articles, and relevant court cases. Companion to the internationally acclaimed text Public Health Law: Power, Duty, Restraint, this reader can also be used as a stand-alone resource for students, practitioners, scholars,and teachers. It encompasses global issues that have changed the shape of public health in recent years including anthrax, SARS, pandemic flu, biosecurity, emergency preparedness, and the transition from infectious to chronic diseases caused by lifestyle changes in eating and physical activity. In addition to covering these new arenas, it includes discussion of classic legal and ethical tensions inherent to public health practice, such as how best to balance the police power of the state with individual autonomy.
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Sunday 1 November 2015

And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition

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And the Band Played On: Politics, People, and the AIDS Epidemic, 20th-Anniversary Edition Description

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Upon it's first publication twenty years ago, And The Band Played on was quickly recognized as a masterpiece of investigatve reporting. An international bestseller, a nominee for the National Book Critics Circle Award, and made into a critically acclaimed movie, Shilts' expose revealed why AIDS was allowed to spread unchecked during the early 80's while the most trusted institutions ignored or denied the threat. One of the few true modern classics, it changed and framed how AIDS was discussed in the following years. Now republished in a special 20th Anniversary edition, And the Band Played On remains one of the essential books of our time.

In the first major book on AIDS, San Francisco Chronicle reporter Randy Shilts examines the making of an epidemic. Shilts researched and reported the book exhaustively, chronicling almost day-by-day the first five years of AIDS. His work is critical of the medical and scientific communities' initial response and particularly harsh on the Reagan Administration, who he claims cut funding, ignored calls for action and deliberately misled Congress. Shilts doesn't stop there, wondering why more people in the gay community, the mass media and the country at large didn't stand up in anger more quickly. The AIDS pandemic is one of the most striking developments of the late 20th century and this is the definitive story of its beginnings.

Upon it's first publication twenty years ago, And The Band Played on was quickly recognized as a masterpiece of investigatve reporting. An international bestseller, a nominee for the National Book Critics Circle Award, and made into a critically acclaimed movie, Shilts' expose revealed why AIDS was allowed to spread unchecked during the early 80's while the most trusted institutions ignored or denied the threat. One of the few true modern classics, it changed and framed how AIDS was discussed in the following years. Now republished in a special 20th Anniversary edition, And the Band Played On remains one of the essential books of our time.

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