Old and Sick in America

September 1, 2017

While the U.S. health-care system as a whole is once again attracting significant attention, Gillick chooses to zero in on one particular segment. A geriatrician at the Division of Aging, Brigham and Women's Hospital, Boston, the author touches on the history of geriatric care and uses individual stories to discuss current policies and practices. Shaped primarily by the interplay of hospitals, physicians, the medical device industry, pharmaceutical companies, and Medicare, which together determine how care is administered and who provides it, the industry is "fragmented, confusing, and alienating." More integrated and cohesive care, better communication among providers, and a greater focus on specifically geriatric needs are needed, as is allowing Medicare to negotiate with drug companies and to consider costs when approving medical devices. Only Medicare, which the author sees as flawed but with a concentration on access to and quality of care, can lever change in the other components and produce improvement. VERDICT With passion and skill, this book offers providers and consumers of health care a rare apolitical analysis of important aspects of the health-care system and how it might be improved.--Richard Maxwell, Porter Adventist Hosp. Lib., Denver

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