Code Blue

March 15, 2019
A doctor and medical historian relies on his experience inside the medical establishment to offer a searing and persuasive exposé of the American health care system.Magee, who is on the faculty of Presidents College at the University of Hartford, has worked as a doctor, a university medical school administrator, a hospital executive, and head of global medical affairs for Pfizer. About that last position, the author writes, "until I turned away in a kind of revulsion at the manipulation and well-financed maneuvering, I was right there, helping give moral cover and scientific legitimacy to the world's largest drugmaker, which also happens to be an industry leader in penalty fees paid to the government for regulatory infractions." Clearly, Magee understands that he has been complicit as an insider, and he issues mea culpas throughout the book. As part of his penance, he blows the whistle on guilty individuals involved with pharmaceutical companies, hospitals, health insurance corporations, the American Medical Association, medical schools, and all levels of U.S. government. Referring to this "network of mutually beneficial relationships" as the Medical Industrial Complex, he convincingly rails against an industry that consistently produces "outcomes that are, in general, truly dismal." The inferiority of U.S. health care compared to dozens of other nations has been well-documented for several decades, and the author effectively builds on that documentation. He demonstrates how leaders of other nations have consciously decided that quality health care is a basic right for all citizens, in large part because a healthy citizenry is essential to economic well-being. However, decades ago, American leaders decided that quality health care was not a basic right of citizenship; instead, they chose to rely on market capitalism as the health care model, with disastrous results. Magee suggests multiple sensible reforms in the realms of medical education, clinical research, publication of medical trials, marketing by pharmaceutical companies, and politically driven interactions within the MIC.Readers will hope that Magee's knowledgeable, urgent indictment, following so many others in recent years, will lead to meaningful reforms.

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April 15, 2019
Hospitals use code blue for medical emergencies; longtime physician Magee argues convincingly that the U.S. itself is in one. How did the health care system get so expensive and inequitable? Part of the blame can fall on the little blue pill, Viagra, which urologist Magee helped promote when he served as the physician-spokesman for it at Pfizer and which lavishly rewarded lobbying and big-money marketing efforts. Pharmaceutical companies gouge Americans. Patients with diabetes often spend more than $570 a month for medication, more than citizens of any other country. Magee explains an alphabet soup of acronyms, including pharmacy benefit managers (PBM's), middlemen who contribute to high drug prices but not to better health. Life expectancy in the U.S. is 78.7 years, lower than the 80.3 average in Canada, Germany, Mexico, France, Japan, and the UK. Magee notes that Warren Buffett recently called medical expenses the tapeworm of American economic competitiveness. What's the solution? Among other things, Magee recommends suspending FDA-approved direct-to-consumer advertising and giving basic universal coverage to everyone. Will his seemingly wise wishes ever come true? Stay tuned.(Reprinted with permission of Booklist, copyright 2019, American Library Association.)