Review by Publisher's Weekly Review
Kaplan, director of research at the Stanford School of Medicine Clinical Excellence Research Center, argues the U.S. health care system is failing because "we measure the wrong things," like cholesterol and other biomarkers, rather than focusing on overall wellness. Now "deeply invested" in expensive biomedical research, the U.S. spends more on health services than other developed nations-$3.2 trillion in 2017-yet Americans have shorter life expectancies and higher infant mortality rates than the populations of those countries. Kaplan blames overinvestment in "moonshot" medicine-the Human Genome Project, for example, and the National Children's Study approved during the Clinton administration-as well as stem cell and gene therapy research, noting that "by 2012, more than 1,800 gene therapy trials were ongoing, but no cures had materialized." Kaplan attempts too broad a critique of the health-care system, branching out into discussions of the flaws of peer review research, the problems with medical clinical trials, and diagnostic errors among physicians. Nonetheless, Kaplan's call to "rethink" how health-care costs could be lowered through greater attention to disease prevention and social and behavioral risk factors is worth noting. (Feb.) © Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
While the United States is the leader by far in per capita spending on health care and producing amazing diagnostic and therapeutic advances, statistics consistently show below-average results in life expectancy and infant mortality compared with other developed countries. Why the disconnect? Former National Institutes of Health chief science officer Kaplan (director of research, Stanford Sch. of Medicine) argues that we spend too much on "curative medicine" and underemphasize social and behavioral factors. Research allocations tend to go to long-existing priorities renewed with little thought, owing to factors such as promotion by advocacy groups and researchers' desire to see their funding continue. New treatments, which may add only months to life, garner headlines and dollars, while lifestyle changes that can potentially improve well-being for decades receive less attention. Admitting the difficulty in both investigating and changing adverse lifestyle factors such as drug/alcohol abuse, smoking, lack of physical activity, and poor diet, the author suggests there's sufficient evidence for altering some of the current focus. VERDICT Thoroughly documented and clearly written, this is for anyone involved in allocating tax dollars at all levels of government and those electing such individuals.--Richard -Maxwell, Porter Adventist Hosp. Lib., Denver © Copyright 2019. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
An argument for redirecting health care funding in the United States, concentrating less on biomedical research and more on social services, thereby improving our general health and preventing overspending.In the U.S., we spend considerably more on developing expensive medical treatments compared to other economically advanced countries, yet we often fall behind in terms of life expectancy and quality of life. So argues Kaplan (Director of Research/Stanford School of Medicine Clinical Excellence Research Center; The Prophet of Psychiatry: In Search of Reginald Ellery, 2015, etc.) in this slim but comprehensive new book. The author rigorously investigates some of the cutting-edge research arease.g., genetic therapy and precision medicinefunded by the National Institutes of Health (where the author was a chief science officer) and influenced by the financial interests of the pharmaceutical industry. He concludes that the promise of generating astounding cures for particular medical problems is considerably stronger than the practice. He appeals for increased funding for improved quality-of-health care that could save thousands of lives, citing the increased number of deaths each year due to poor treatment and medical errors (the third-leading cause of death behind heart disease and cancer). Kaplan further considers issues around race, financial inequality, and lack of education, pointing to the increased death rates in more impoverished parts of the country where medicine has done little to improve health outcomes. Ultimately, the author is not opposed to biomedicine, but he seeks urgent reforms in how we allocate funding. "It is not my contention that biomedicine is inherently harmful or useless. Far from it," he writes. "It is my contention that researchers and the wider citizenry should continually debate strategies for extracting public benefit from scientific knowledge. I believe that an open debate, accountable to the latest evidence, will inspire significant reforms."Sharp, authoritative, and intensely data-driven. Though it reads like an expanded article for a professional medical journal, the argument is deeply compelling. Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
