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Managed care CAN be a good thing, if used right. However, there is a point to where doctors get greedy. So many times there are tests that are performed that aren't really necessary, but if the doctor can perform them, then they will - and bill the insurance for as much as they can get. Granted, if they don't have insurance, the patient eventually gets harassed by bill collectors. But, what is NOT mentioned in here is how doctors still get paid, even if the bill goes unpaid by a patient. They have insurance for that, to which they cry for as much money as possible.
I apologize to this author, but what has been written here is pure hogwash. Managed care does have its problems, but what it DOES do is prohibits doctors from gutting the American citizen's wallets and lining their own. Clearly, this book is an attempt by this doctor to coax money from the people in order to make up for what managed care has cost him to lose.
The author, himself a physician, makes no bones about the faults of the medical profession and speaks openly and honestly about physicians who place the interests of health plans above those of their patients. He presents five horrifying examples of the ultimate harm this ethical adulteration has caused to patients and devines the common denominator in each example to be the relationships providers have with health plans. He argues elogently that managed care is the ultimate seduction of the "physician" which causes them to place their economic survival above the survival of those for whom they care and to whom they owe a duty.
What is most frightening about these examples is that the medical conditions treated in each were not complicated problems, but, instead, were common simple things for which anyone of us could go to a doctor. In his summation of these anecdotes he says of managed care, "Mary Shelley, the author of Frankenstein, told a story about a doctor who created a monster. These chapters tell a story about a monster that created a doctor."
Even so, this book is not merely a collection of medical horror stories. These stories are more for effect than style. They are used by the author as a devise to set up his argument that health care is a fundamental right for all Americans. The ultimatate purpose of the book is to formulate a new paradigm for American health care based on this principle. I must say that the author does so in a very compelling manner.
He presents his vision as the hypothetical "Ideal Universal Health Care Act." Although fantasful legislation, it is not merely a product of the author's imagination; instead, it is very plausable. His vision is the product of a thoughtful mind and, consequently, it is and should be thought provoking to anyone who reads it.
For a first time author, Dr. Smith makes a very important statement and I hope this book receives the recognition that it deserves.
Nevertheless Mr. Davis was correct in one account; this book is written through the eyes of a physician. It's name, Finding Hippocrates does not disquise whose perspective this book may represent. But this author is no "ersewhile doctor." Instead, he writes with a passion about these issues that more physicians...many more physicians... need to rekindle. That is why this book is so beautiful.
This author does not whine about managed care's intrusion in his earning potential. In fact, nothing in the book even suggests this. He talks about physicians who are medical predators and he makes a very pithy statement that "the licence to practice medicine is not a licence to steel." Although he is a disillusioned physician he is not a disgruntled one.
None the less, he does admit to being angry. However, he is not angry at health plans; instead, he is angry at hospitals, the government, patients, the medical profession and himself. This doesn't sound like some self-serving polemic to justify an attack on the insurance industry to me. The author's anger is not misdirected and because of this he directs his anger to find a solution. First he explores the history of health insurance in a very understandable way. Then, he examines the efforts of Bill Clinton to reform health care in an extraordinarily honest and absolutely brilliant expose' which makes one wonder if he was an insider to these proceedings when they were occurring. Finally, he offers a solution which is so compelling that it makes me hope and pray that it is read by those in positions who have the power to realize this vision. This is an extreemly well written book. It clearly articulates the authors passion and vision. It provided a comprehensive and understandable explanation of the health care system and health care legislation from the turn of the century to ERISA and the Patient Bill of Rights. It concludes by creating a future paradigm for health care policy that sounds completely workable and logical. Most extraordinarily it does all this in only 206 pages, an accomplishment, itself, worthy of immediate kudos. I wish this author well and can honestly say that medicine needs more doctors with the vision of Howard Smith, M.D.
If your involvement in psychology is limited to reading "Psychology Today" magazine, this may not be for you. I find this text does not devote enough space in the discussion of 20th century theories of and treatments for depression and melancholia. I would prefer more space to a discussion of A. T. Beck and Martin E. P. Seligman's views of depression. Because I am a student of "attribution theory," I would have liked to see a fuller development of the work Seligman started and which was more fully developed by Lyn Abramson and associates. Modern psychiatry tends to view depression in terms as an imbalance of certain neurotransmitters in the brain and treats it with antidepressants including MAO inhibitors and the more modern selective seratonin reuptake inhibitors such as Prozac, Zoloft, and Paxil, to name a few. I would also have been happier with more full discussion of psychopharmacological intervention.
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