Crisis in US Health Care: Corporate Power vs the Common Good

Alida M. Gertz, MD, MPH

Fam Med. 2018;50(5):395-396.

DOI: 10.22454/FamMed.2018.995811

Book Title: Crisis in US Health Care: Corporate Power vs the Common Good

Book Author: John Geyman

Publication Information: Friday Harbor, WA, Copernicus Healthcare, 2017, 358 pp., $18.95, paperback

Crisis in US Health Care: Corporate Power vs the Common Good by John Geyman, is a must-read not only for family medicine physicians, but also for anyone interested in how the American health care system has devolved to the dysfunctional state we find it in today. Although it has served well the few who have managed to profit immensely from the corporatization and privatization of the system, in becoming a business, it has strayed far from the social service that it is in most developed countries, and in one of the richest countries in the world, health care is no longer considered a human right, but instead, a commodity to be bought and sold.

Dr Geyman is the perfect bearer of this bad news, as his decades of experience dating from the 1960s to the present in family medicine as a rural practitioner, as a department chair, as a residency director, as a journal editor, and as a writer, among other roles, give him a unique and clear perspective of the changes that have occurred over time and that have brought us to where we as Americans find ourselves today. 

The book traces the history of medicine in the United States starting in the mid 20th century just before Medicare was enacted, and tells the story of the political and economic forces that shaped our health care system. The first part of the book details systems changes over the past 60 years, while the second part chronicles a personal perspective during this same time frame. The final part, a summary of the state of the health care system today, also gives some insight into possible future directions.

Dr Geyman builds on the work of many other writers, doctors, academicians, businessmen and women, and historians to support his perspectives and the details of his story. He clearly has a firm grasp on research that has shown what works and what doesn’t work to improve the health of a population, and he is very adept at pointing out what we as a profession have done well and what we have done poorly to serve or disserve the American people.

Much of the book focuses on the intricate tale of how market forces and insurance companies inched their way into power, and slowly eroded the medical system and its value system until money ruled, and social justice, and physicians’ sense of service, fell to the wayside. His remarkable descriptions of the series of circumstances and decisions that led us astray are beautifully told in this book, which can only be described as a work of art.

Clearly a proponent of a single-payer system, Dr Geyman explains why the current system, including the Affordable Care Act, and particularly any system the Trump administration puts in its place, has been and will continue to be a system that serves the interests of big business only, and not the interests of the population, nor individual health care as a human right, nor public health. A single-payer system, he argues, as most developed nations have moved to, is the only system that will fairly serve all, and is the only system that, if implemented, could salvage American health care from the nearly unsalvageable wreckage it has become.

The best part of this book is that Dr Geyman takes his readers through the evidence in such an easily accessible and understandable manner, and his arguments are so eloquently made that one is tempted to think that they almost came up with the ideas and flow of logic themselves. At over 80 years of age, he sees our flawed system with such clarity, his writing is so fluid, and his point-by-point plans for working toward a better health care system are so cogent that this is easily the best book on the problems and potential solutions to our broken health care system that has been written in the last 20 years. I highly recommend it to anyone interested in the subject, or in fact to just anyone who is a citizen of the United States.

Lead Author

Alida M. Gertz, MD, MPH

Affiliations: University of Washington School of Public Health Seattle, WA

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