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Radical Surgery: What's Next for America's Health Care

Radical Surgery: What's Next for America's Health Care

by Joseph A. Califano, Jr.
The Washington policy maker and renowned author of AMERICA'S HEALTH CARE REVOLUTION heats up the health-care debate, with a warning against "sick care" and a call for patient empowerment.


The Washington policy maker and renowned author of AMERICA'S HEALTH CARE REVOLUTION heats up the health-care debate, with a warning against "sick care" and a call for patient empowerment.

Editorial Reviews

Publishers Weekly - Publisher's Weekly
Noting that only three cents of every health care dollar goes to preventive measures, Califano urges massive governmental, business and community efforts to promote good health in this thought-provoking blueprint for overhaul of the nation's health care system. Drawing on his experience as secretary of health, education and welfare under the Carter administration, architect of Medicare and Medicaid under Johnson, chair of Chrysler's health care committee and president of Columbia University's Center on Addiction and Substance Abuse, Califano urges Americans to mount an all-fronts attack on abuse and addiction involving nicotine, alcohol and other drugs. He urges timely preventive care, particularly for pregnant women, babies, children and the elderly, as well as a coordinated attack on activities that send medical costs skyrocketing-reckless driving, air and water pollution, poor diet, violent crime, toxic lead-filled paint, teenage pregnancy and behavior contributing to sexually transmitted diseases.Califano's proposals are certain to stir controversy. Calling for an end to doctor's medical monopoly, he recommends an expanded role for physician assistants, nurses and midwives, as well as incentives for specialists to use costly tests and treatments only when absolutely necessary. His carrot-and-stick approach envisions company bonuses for healthy employees and insurance penalties for those who fail to pursue healthy habits. Charging that Congress, beholden to health industry lobbyists, has thwarted viable cost-cutting reforms, the author sketches a ``clean and lean'' plan to phase in affordable, universal medical insurance by combining government-mandated employers' benefits packages with the extension of Medicare to the poor and unemployed. (Jan.)
Library Journal
In his earlier book, America's Health Care Revolution (LJ 3/15/86), Califano concentrated on the financing and delivery of healthcare services. Here, he "deals with more fundamental, closer-to-the-heart-mind-and-soul matters, the promise and pitfalls ahead, the corruption of Congress, and the medical miracles and emotional mayhem that our scientific genius and self-indulgence hold in store for each of us." He warns that tampering with the healthcare industry (one-sixth of the nation's economy) will bring ripples of unexpected consequences that could grow into tidal waves. Califano draws on his own experiences in the government (he was Secretary of Health, Education and Welfare under President Jimmy Carter) and in corporations to bring a refreshingly breezy, impassioned, and informative perspective to the healthcare reform debate. Essential for health and public policy collections.-James Swanton, Albert Einstein Coll. of Medicine, New York
Califano urges bold action to save the best of American medicine, nourish its genius, contain its costs, and democratize its miracle cures, warning that the obsession of the nation's politicians with raising campaign money and their fetish with financing and delivering sick care will continue to push up costs and limit the number of Americans with access to care. Successful reform must reshape not just the treatment of illness and injury, he claims, but also where the nation invests its research dollars and how much it devotes to prevention. Annotation c. Book News, Inc., Portland, OR (booknews.com)
Mary Carroll
Califano has a long history with the health care system. He tried to cut medical costs at Robert McNamara's Pentagon, helped LBJ with Medicare and Medicaid, led Carter's Department of Health, Education & Welfare, and now heads Columbia University's Center for Addiction and Substance Abuse (which will receive this book's royalties). The author has also raised a son who is now an otolaryngologist; served on the boards of Chrysler, Aetna, and New York Hospital; represented drugmakers and health care providers as an attorney; watched his parents die at home and his father-in-law, Bill Paley (of CBS), fight to stay alive; and lost a big chunk of his own intestine to surgery. Understandably, Califano focuses on personal responsibility and on shifting the system's emphasis from "sick care" to health promotion and preventive medicine. Skeptical now of legislative solutions ("No one is smart enough to write a single law to revamp the entire health care system"), Califano supports campaign finance reform, an employer mandate, and extension of Medicare to cover those ineligible for employer plans. His remedies include: legal action on (and research into) "causes" of sickness and injury (particularly legal and illegal drugs, guns, sexual promiscuity, and poverty and discrimination); breaking up "the medical monopolies"; and public participation in a national debate on the crucial values questions implicit in our technological advances and in our sometimes skewed cultural attitudes toward health and sickness, life and death.

Product Details

Crown Publishing Group
Publication date:
Edition description:
1st ed
Product dimensions:
6.44(w) x 9.52(h) x 1.33(d)

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