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Book and Media Reviews
August 19, 2009

Flatlined: Resuscitating American Medicine

JAMA. 2009;302(7):802-803. doi:10.1001/jama.2009.1220

On June 1, 2009, General Motors declared bankruptcy. Some blame management, others blame labor. But 39% of a 2005 GM employee's hourly wage was related to health care costs—costs that management and labor were powerless to control. Two trillion dollars a year—16.5% of the gross national product—is spent on health care in the United States. Medicare and Medicaid expenditures account for 23% of the federal budget and are increasing faster than suspected global temperatures. If trends continue, polar bears are likely to stay afloat longer than the current health care system. Expense is not the only problem. Eighty-two million nonelderly US individuals have “insufficient, unstable, or no insurance coverage” (p xii). With an abundance of raw statistics such as these, Guy Clifton is able to draw readers into his treatise on the health care conundrum. Clifton argues that the US health care system is inefficient and expensive, providing limited access and variable quality. While somewhat overambitious, Clifton's solutions offer insight into the complexity of a system in urgent need of change.