by Jeanne Kassler, 239 pp, $21.95, ISBN 1-55972-223-1, New York, NY, Carol Publishing Group, 1994.
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Bitter Medicine is a report on the condition of American health care from an angry physician's perspective, written to those concerned with the entry of large business into health care delivery and financing. As the health care reform debate continues in a turbulent environment, this book provides useful insight into many of the issues and publics that have shaped medicine today. More important, it also outlines the goals that should be integral to any health care system that is finally adopted. It is a clinician's view of what makes the current system falter. As such, it is at times a diatribe against many recent innovations, but change should be examined critically.
Much of Kassler's discussion focuses on the issue of money, where it is and how it affects medicine. She acknowledges that the chief problem in American health care is its costs, and that traditional medical ethics is challenged by
Kirkman-Liff B. Bitter Medicine: Greed and Chaos in American Health Care. JAMA. 1995;273(11):895. doi:10.1001/jama.1995.03520350077039