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Book and Media Reviews
March 26, 2008

The Health Care Fix: Universal Insurance for All Americans

JAMA. 2008;299(12):1480-1481. doi:10.1001/jama.299.12.1480

Both the medical and lay presses are awash in books and articles on the “health care dilemma,” in the United States, and the presidential campaign has only increased the printed plethora of solutions to the crisis. As of November 2007, Amazon.com listed more than 3335 titles on the health care crisis and 7707 on health care reform. If I had a dollar for every title about the dysfunctional health care system, I would have little difficulty paying my medical premiums.

Most current books on health care reform follow a standard pattern. An opening section typically outlines the present and future medical and monetary troubles due to the current system—eg, 47 million uninsured individuals, the inundation of baby boomers, elderly care costs, future destruction of life on earth. A second section usually presents such topics as the perils and advantages of “socialized medicine,” faults and advantages of the British/Canadian/Berzerkistan system, pluses and minuses of “Hillary care,” and the positives and negatives of Bush's plans. A third section then often provides a specific fix for health care problems. These solutions usually look good but tend to underestimate costs, avoid the fact that no society can have everything it wants, or else attribute to all—patients, health workers, pharmaceutical manufacturers—wondrous, philanthropic instincts that do not necessarily exist in the real world. The cliché that “the devil is in the details” is central in all discussions. One cannot blame the average reader for slipping into a twilight zone of nonattention on entering the printed world of health care reform.