How to Make a Killing: Blood, Death and Dollars in American Medicine

by Tom Mueller Narrated by Melissa Kay Benson

Overview

Six decades ago, visionary doctors achieved the impossible: the humble kidney, acknowledged since ancient times to be as essential to life as the heart, became the first human organ to be successfully replaced with a machine. Yet huge dialysis corporations, ambitious doctor-entrepreneurs, and Beltway lobbyists soon turned this medical miracle into an early experiment in for-profit medicine-and one of the nation's worst healthcare catastrophes.



With powerful insight and on-the-ground reporting, Tom Mueller introduces an unforgettable cast of characters. Heroic patients risk their lives to blow the whistle on how they've been mistreated. An unpaid activist living in a south Georgia trailer park fights to save patients from involuntary discharge from their lifesaving care. Industry insiders put their careers on the line to speak out about the endemic wrongs and pervasive inequality they've witnessed-and about dialysis executives who dress as musketeers and Star Wars characters to exhort their employees to more aggressive profit-seeking.



How to Make a Killing reveals dialysis as a microcosm of American medicine and poses a vital challenge: find a way to fix dialysis, and we'll have a fighting chance of fixing our country's dysfunctional healthcare system as a whole, restoring patients, not profits, as its true purpose.

Editorial Reviews

From the Publisher

"A rich and sweeping saga that is, sadly, a quintessentially American story: how a miracle medical machine transformed into profit machine, sick and suffering patients be damned."— Jesse Eisinger, author of The Chickenshit Club

"[A] grimly fascinating and humane exposé.… [E]ye-opening."— Steven Poole Telegraph

"An important book holding to account those who abuse the system, from the local strip mall dialysis center to the halls of the U.S. Capitol."— Ron Sylvester Spokesman-Review

"Tom Mueller goes deep, then wide, then straight for the jugular of the corporate predators who are getting rich by exploiting the poor and vulnerable. This book raised my blood pressure by at least thirty points."— Carl Elliott, author of The Occasional Human Sacrifice

"I loved Tom Mueller’s beautifully written and fascinating account of both the miraculous possibilities of medical technology and the perils of poorly structured markets. There is universal medical care in the United States, but only for kidney disease. How a program started by Richard Nixon and corrupted by finance has saved lives, and cost them, is the story of modern America."— Matt Stoller, author of Goliath: The Hundred Year War Between Monopoly Power and Democracy

"A terrifying story of profit before patients, and a chilling glimpse of what can happen when private companies are allowed to take charge of healthcare."— Gavin Francis, author of Recovery: The Lost Art of Convalescence

"We have accepted too much for too long. There are those who will say that the book exaggerates and that things he reports don’t happen. Maybe they don’t in some/most clinics, but even if they happen in a few clinics, we can do better."— Beth Witten, Home Dialysis Central

"We urge you to stop what you’re doing, buy this book, and read it from cover to cover. The book presents nothing short of an indictment of rabid capitalism run amok, effectively turning what should be a life-saving branch of medicine into a criminal enterprise."— Pam and Russ Martens Wall Street on Parade

"New York Times best-selling author Tom Mueller very well could be rocking the foundations of many a corporate boardroom with this book."— DialysisEthics.org

"A brilliant expose of one of the darkest corners of healthcare. This story must be told—to protect some of America’s most vulnerable of patients, but also the people who care for them."— Kimberlee Langford, registered nurse and vice president of clinical services at Specialty Care Management

"Tom Mueller does a fantastic job of meticulously categorizing and explaining all of the abuses of power. I highly recommend How to Make a Killing."— Dr. Eric Bricker, founder of AHealthcareZ

"A must-read for clinicians, patients, economists, policymakers, and anyone interested in improving healthcare. Through exhaustive research and simple yet dramatic language, Tom Mueller reveals some of the biggest, darkest secrets in US healthcare."— Kevin Weinstein, CEO of Renalogic

"Insightful, infuriating, and inspiring. As both the family member of someone who has been on dialysis for more than a decade and a practicing physician, I am deeply grateful for the journalistic work of Tom Mueller."— Tyler Wellman, MD

Kirkus Reviews

2023-06-28
A dispiriting look at the replacement of the Hippocratic oath by a PIN number that centers on the big business of kidney dialysis.

Basing his account on interviews with hundreds of constituents of the “dialysis community,” journalist Mueller, author of Extra Virginity and Crisis of Conscience, describes a health care industry that is seemingly entirely focused on profit. Most dialysis takes place at clinics where a premium is placed on getting patients in and out quickly, with the withdrawal and reinsertion of blood occurring more rapidly than the body can comfortably accommodate—even though in many instances, “when administered this way, dialysis may shorten patients’ lives by stripping off bodily fluids too fast, triggering sudden drops in blood pressure that can damage the heart, brain, gut, and lungs and lead to stroke, congestive heart failure, and cardiac arrest.” If you complain, you’re likely to be denied care—and, worse, far too many nephrologists are disinclined to fight on behalf of their patients. One nephrologist recounts that a colleague told her he had developed “techniques for goading undesirable patients into acting out, in order to eject them from his facility.” Most of these patients are insured by Medicare or Medicaid, a system that pays less than private insurance. Against the American system of “bazooka dialysis,” most advanced countries use a slower, more frequent program of dialysis. Furthermore, many of them place the locus of dialysis at home, with patients self-administering their care, a method that the American medical system lobbied hard to discourage. Some American physicians are bucking the system, Mueller writes, and the Trump administration issued an executive order demanding improved care—likely only because, Mueller ventures, Health and Human Services Secretary Alex Azar’s father “had been on dialysis for several years.” Even so, the system remains a mess, and bad actors are seldom punished.

An indignant, urgent indictment of the for-profit American way of medical care.

2024 NYPL Helen Bernstein Award, Short-listed

Product Details

BN ID:	2940159288653
Publisher:	HighBridge Company
Publication date:	10/24/2023
Edition description:	Unabridged

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