BMJ  2008;336:99 (12 January), doi:10.1136/bmj.39423.674329.94

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What is wrong with US health care

The problems with the American healthcare system are brilliantly laid out in this new book. But overtreatment isn’t the whole story, and fixing the system is another matter, says Douglas Kamerow

The first 150 words of the full text of this article appear below.

Yet another book about the healthcare "system" everyone loves to hate? Yes, indeed, but this is a good one. Journalist Shannon Brownlee systematically documents the problems of health care in America, deftly mixing statistics with telling anecdotes and quotations. Along the way she also profiles healthcare heroes and villains at greater length.

If you ask doctors why health care costs so much in the United States, we’ll tell you that it is the for-profit medical system and litigious lawyers that are the problem. Drugs cost too much because of the rapacious drug companies. Administrative costs are too high and are multiplied by the vast number of health plans and insurance companies. And because we’re worried about lawsuits, we practise defensive medicine and order too many tests so we don’t miss anything.

Brownlee enumerates and rejects most of these explanations. She uses overtreatment as her organising principle and the ultimate cause . . . [Full text of this article]

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No laughing matter

Douglas Kamerow
BMJ 2007 335: 47. [Extract] [Full Text] [PDF]

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