The problems of medical care confront us daily: a bureaucracy that makes a trip to the doctor worse than a trip to the dentist, doctors who can't practice medicine the way they choose, more than 40 million people without health insurance. "Medical care is in crisis," we are repeatedly told, and so it is. Barely one in five Americans thinks the medical system works well. Enter David M. Cutler, a Harvard economist who served on President Clinton's health care task force and later advised presidential candidate Bill Bradley. One of the nation's leading experts on the subject, Cutler argues in Your Money or Your Life that health care has in fact improved exponentially over the last fifty years, and that the successes of our system suggest ways in which we might improve care, make the system easier to deal with, and extend coverage to all Americans. Cutler applies an economic analysis to show that our spending on medicine is well worth it--and that we could do even better by spending more. Further, millions of people with easily manageable diseases, from hypertension to depression to diabetes, receive either too much or too little care because of inefficiencies in the way we reimburse care, resulting in poor health and in some cases premature death. The key to improving the system, Cutler argues, is to change the way we organize health care. Everyone must be insured for the medical system to perform well, and payments should be based on the quality of services provided not just on the amount of cutting and poking performed. Lively and compelling, Your Money or Your Life offers a realistic yet rigorous economic approach to reforming health care--one that promises to break through the stalemate of failed reform.

Marc A. Rodwin draws on his own experience as a health lawyer--and his research in health ethics, law, and policy--to reveal how financial conflicts of interest can and do negatively affect the quality of patient care. He shows that the problem has become worse over the last century and provides many actual examples of how doctors' decisions are influenced by financial considerations. We learn how two California physicians, for example, resumed referrals to Pasadena General Hospital only after the hospital started paying $70 per patient (their referrals grew from 14 in one month to 82 in the next). As Rodwin writes, incentives such as this can inhibit a doctor from taking action when a hospital fails to provide proper service, and may also lead to the unnecessary hospitalization of patients. We also learn of a Wyeth-Ayerst Labs promotion in which physicians who started patients on INDERAL (a drug for high blood pressure, angina, and migraines) received 1000 mileage points on American Airlines for each patient (studies show that promotions such as this have a direct effect on a doctor's choice of drug). Rodwin reveals why the medical community has failed to regulate conflicts of interest: peer review has little authority, state licensing boards are usually ignorant of abuses, and the AMA code of ethics has historically been recommended rather than required. He examines what can be learned from the way society has coped with the conflicts of interest of other professionals --lawyers, government officials, and businessmen--all of which are held to higher standards of accountability than doctors. And he recommends that efforts be made to prohibit and regulate certain kinds of activity (such as kickbacks and self-referrals), to monitor and regulate conduct, and to provide penalties for improper conduct. Our failure to face physicians' conflicts of interest has distorted the way medicine is practiced, compromised the loyalty of doctors to patients, and harmed society, the integrity of the medical profession, and patients. For those concerned with the quality of health care or medical ethics, Medicine, Money and Morals is a provocative look into the current health care crisis and a powerful prescription for change.

A unique historical review that traces health spending from ancient times to the present and forecasts 21st century trends. There are many histories of medicine, yet none that assess the dynamics of expenditures over decades and centuries. Economists have not yet addressed the magnitude of the transformation that occurred during the twentieth century as payments shifted from solo physician practices to health systems, nor the legacy effects of social practices accumulated over millennia that will shape health spending in the twenty-first. In Money and Medicine, Thomas E. Getzen provides a unified narrative of medical spending from ancient Egypt and Babylonia to the present day. Drawing on a wealth of historical reports, data, and documents, Getzen concentrates on a single ratio-the share of income devoted to medical care-to frame the evolutionary path of medicine, revealing an S-shaped growth curve that rose rapidly after 1900 as science made therapies more effective and more expensive, inflected as national health systems coalesced and rates of expansion peaked in the 1960s, then decelerated after 1975. International trends in forty-three countries are graphically illustrated with analysis supporting a parsimonious financial model. Significant lags are seen between medical innovation or macroeconomic shocks and the corresponding changes in national health expenditures. Getzen explains inertial responses to the 2008 financial crisis and Covid-19 recession, provides a method for projecting trends over the next fifty years, and suggests why spending is so much higher in the United States than other countries. As rising costs and unequal distribution of medical care have created a sense of crisis in many countries, Money and Medicine shows that we must look beyond the last few years to craft sensible solutions.

Decolonizing Wealth is a provocative analysis of the dysfunctional colonial dynamics at play in philanthropy and finance. Award-winning philanthropy executive Edgar Villanueva draws from the traditions from the Native way to prescribe the medicine for restoring balance and healing our divides. Though it seems counterintuitive, the philanthropic industry has evolved to mirror colonial structures and reproduces hierarchy, ultimately doing more harm than good. After 14 years in philanthropy, Edgar Villanueva has seen past the field's glamorous, altruistic façade, and into its shadows: the old boy networks, the savior complexes, and the internalized oppression among the “house slaves,” and those select few people of color who gain access. All these funders reflect and perpetuate the same underlying dynamics that divide Us from Them and the haves from have-nots. In equal measure, he denounces the reproduction of systems of oppression while also advocating for an orientation towards justice to open the floodgates for a rising tide that lifts all boats. In the third and final section, Villanueva offers radical provocations to funders and outlines his Seven Steps for Healing. With great compassion—because the Native way is to bring the oppressor into the circle of healing—Villanueva is able to both diagnose the fatal flaws in philanthropy and provide thoughtful solutions to these systemic imbalances. Decolonizing Wealth is a timely and critical book that preaches for mutually assured liberation in which we are all inter-connected.

Prescription drug prices rose three times faster than inflation in the last decade. Here, two Philadelphia Inquirer reporters show how the industry has circumvented every governmental effort to bring prices under control. Drug companies raise prices when faced with competition, are granted monopoly markets, and profit from research breakthroughs by government and academic scientists.

"This book frames the evolutionary path of medicine and provides a useful forecasting model. Tracing health spending from ancient times to the present with a single ratio, health expenditures as a share of income, reveals an s-shaped growth curve, rising rapidly after science made therapies more effective and more expensive, inflecting as the rate of expansion peaked with the coalescence of national health systems in the 1960s, and decelerating after 1975. Medicine became qualitatively different as it scaled up along therapeutic, organizational, financial, and moral dimensions. The development of health insurance and changes in the flow of funds made macro effects on total spending different from micro determinants of allocation. Institutional inertia and lags require a span of observation long enough to distinguish temporary fluctuations from shifts in trend"--