Dissecting American Health Care

Acknowledgments v
Introduction vi
1. Assessing and Improving Health Care 1
Great health care, guaranteed 3
Retail health clinics—threat or promise? 6
CAM to the rescue 9
Paying for promising but unproven technologies 12
Waiting for the genetic revolution 15
Separating medical truth from fiction 18
Testing errors in the doctor’s office 20
Scientists shed light on festive medical myths 22
Hospitalists—a new kind of doctor 24
2. Preventive Medicine 27
Should we screen for childhood dyslipidemia? 29
Weighing prostate cancer screening recommendations 32
Shouting about shots 34
The good news about the flu 37
Does preventive care save money? 39
Debate over the H1N1 vaccine? There shouldn’t be one 41
Mammograms, poor communication, and politics 43
Is hypertension really a neglected disease? 46
Depressed about depression 49
Screening for early detection of lung cancer 52
AIDS at 30: A chance to treat is a chance to prevent 55
3. Politics, Health, and Health Care 59
Today’s doctors’ dilemma 61
The cancer diagnosis that has gripped America 64
What the candidates fail to mention 70
A cautionary tale for the presidential candidates 73
What should the surgeon general do? 76
The taxing case of Tom Daschle 79
The papal position on condoms and HIV 82
The case of the sugar-sweetened beverage tax 85
Smoking or obesity: must we target only one? 88
Guns don’t kill crowds, people with semi-automatics do 91
The rise and likely fall of Don Berwick 94
4. Health Care Reform 97
Our perfectly designed health care system 99
How to waste a billion dollars 102
Who will pay and who will say no? 105
The gatekeeper and the wizard, redux 108
All or nothing at all? 110
US health care reform is in the waste can 113
Prevention and the new US health reform act 116
PCORI: odd name, important job, potential trouble 119
5. Personal Stories and Ethical Issues 123
Killing me softly 125
Medicare Part D signup blues 128
Who wrote that article? 130
Aesculapius on a plane 133
Placebo pills for children 136
No gifts, please, we’re doctors 139
What I learned from Mom 142
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Dissecting American Health Care is published by RTI Press, Research Triangle Park, NC