Code Blue: Inside America's Medical Industrial Complex

by Mike Magee

Overview

A powerful and path-breaking expose of America’s Medical Industrial Complex—the network of mutually beneficial relationships between big business, academic medicine, patient advocacy organizations, hospitals, and government—and a compelling way forward for transforming America’s healthcare system

How has the United States, with more resources than any nation, developed a healthcare system that delivers much poorer results, at near double the cost of any other developed country—such that legendary seer Warren Buffett calls the Medical Industrial Complex “the tapeworm of American economic competitiveness”? Mike Magee, M.D., who worked for years inside the Medical Industrial Complex administering a hospital and then as a senior executive at the giant pharmaceutical company Pfizer, has spent the last decade deconstructing the complex, often shocking rise of, and connectivity between, the pillars of our health system—Big Pharma, insurance companies, hospitals, the American Medical Association, and anyone affiliated with them. With an eye first and foremost on the bottom line rather than on the nation's health, each sector has for decades embraced cure over care, aiming to conquer disease rather than concentrate on the cultural and social factors that determine health. This decision Magee calls the “original sin” of our health system.

Code Blue is a riveting, character-driven narrative that draws back the curtain on the giant industry that consumes one out of every five American dollars. Making clear for the first time the mechanisms, greed, and collusion by which our medical system was built over the last eight decades—and arguing persuasively and urgently for the necessity of a single-payer, multi-plan insurance arena of the kind enjoyed by every other major developed nation—Mike Magee gives us invaluable perspective and inspiration by which we can, indeed, reshape the future.

Product Details

ISBN-13:	9780802148940
Publisher:	Grove/Atlantic, Inc.
Publication date:	04/21/2020
Pages:	432
Product dimensions:	5.40(w) x 8.20(h) x 1.20(d)

About the Author

Mike Magee, MD, is a medical historian and journalist on the faculty of Presidents College at the University of Hartford. He has held similar roles at a range of academic institutions. He was a Honorary Master Scholar at the NYU School of Medicine and a Distinguished Alumnus award recipient from the University of North Carolina School of Medicine. Beginning as a country doctor in western New England, he rose to the highest level of his profession holding senior executive positions at Pennsylvania Hospital in Philadelphia, and as head of global medical affairs for Pfizer. He is editor of the blog HealthCommentary.org.
mikemagee.org healthcommentary.org
@hcommnews

Table of Contents

About the Title ix

1 The Constant Gardener 1

2 Intertwined 10

3 Government Steps In 29

4 The War of Science against Disease 51

5 Advocates 72

6 The House of God 95

7 Insuring Complexity 121

8 Masters of Manipulation 150

9 Equal Parts Politics and Science 180

10 Strange Bedfellows: Health Care, Politics, and the Christian Right 201

11 Nigeria, CROs, and Research Biases 223

12 Viagra: "Everything That Rises Must Converge" 243

13 New Rules 266

14 Time to Deal 289

15 The MIC-"Tapeworm of American Economic Competitiveveness" 301

Afterword 323

Appendix: Time Line of Pfizer's Penalties and Transgressions 325

Acknowledgments 331

Notes 335

Index 405

Editorial Reviews

Praise for Code Blue:

“Show[s] readers that the present dysfunction in U.S. health care is not an aberration, but a persistent feature of a system ruled by self-interested institutions . . . The material on Big Pharma is where the book cuts deepest . . . [Magee] describes a world in which needed drugs are not produced because profits don’t justify it, but huge research-driven pharma companies cry foul when their work benefits the public cheaply after patents expire.”—Minneapolis Star Tribune

“Utilizing a character-drawn structure to lend narrative flow to the book, Magee has penned a provocative and riveting read.”—The Day

“A searing and persuasive exposé of the American health care system . . . The inferiority of U.S. health care compared to dozens of other nations ahs been well-documented for several decades, and the author effectively builds on that documentation. He demonstrates how leaders of other nations have consciously decided that quality health care is a basic right for all citizens, in large part because a healthy citizenry is essential to economic well-being. However, decades ago, American leaders decided that quality health care was not a basic right of citizenship; instead, they chose to rely on market capitalism as the health care model, with disastrous results . . . Readers will hope that Magee’s knowledgeable, urgent indictment, following so many others in recent years, will lead to meaningful reforms.”—Kirkus Reviews (starred review)

“Hospitals use ‘code blue’ for medical emergencies; longtime physician Magee argues convincingly that the U.S. itself is in one . . . What’s the solution? Among other things, Magee recommends suspending FDA-approved direct-to-consumer advertising and giving basic universal coverage to everyone.”—Booklist

“As we did with Big Tobacco, Mike Magee skillfully exposes a collusive web of businesspeople who restructured health care to deliver profit in the billions. With an eye toward justice, Code Blue traces eight decades of wrongdoing. This is public service at its best!”—Mike Moore, former Attorney General of Mississippi, and lead attorney, Tobacco Master Settlement Agreement

“A tour de force from Mike Magee who explains how our Medical Industrial Complex evolved to its current bloated, inequitable state. Extensive research and insights from his diverse experience support the diagnosis of Code Blue and outline the steps we need to take to fix it.”—Susan M. Love, MD, author of Dr. Susan Love’s Breast Book

“Urgent. Sobering. Revelatory. The cost of health care in America keeps rising while the quality of care is falling. And why? Because, as Dr. Mike Magee explains, profiteering, rather than an interest in people’s health, has over time become the raison d’être of care in the U.S. Read this book to learn how we got to this crisis moment, and, most importantly, how we can work together to get beyond it.”—Theresa Brown, RN, author of The Shift and Critical Care

“Pharmaceutical industry insider Dr. Mike Magee exposes the deep financial ties between U.S. medicine and profit-driven business. This book is chock-a-block full of the kinds of facts you sense are there but need an experienced guide to point out. If you want to know where all that money goes and why Americans are so unhealthy, this is the book for you.”—John Abramson, MD, MSc, Lecturer, Department of Health Care Policy, Harvard Medical School and author of Overdo$ed America

“Ida Tarbell and Leo Tolstoy had a baby, and it was called Code Blue. If you want stories of corruption reminiscent of Tarbell’s muckraking, and you want to combine them with a sweep of history and personalities that is Tolstoyan, this book is for you. If you’ve resisted the idea of single payer, Code Blue is highly likely to change your view.”—Mitzi Perdue, author of How to Make Your Family Business Last

From the Publisher

★ 2019-02-28

A doctor and medical historian relies on his experience inside the medical establishment to offer a searing and persuasive exposé of the American health care system.

Magee, who is on the faculty of Presidents College at the University of Hartford, has worked as a doctor, a university medical school administrator, a hospital executive, and head of global medical affairs for Pfizer. About that last position, the author writes, "until I turned away in a kind of revulsion at the manipulation and well-financed maneuvering, I was right there, helping give moral cover and scientific legitimacy to the world's largest drugmaker, which also happens to be an industry leader in penalty fees paid to the government for regulatory infractions." Clearly, Magee understands that he has been complicit as an insider, and he issues mea culpas throughout the book. As part of his penance, he blows the whistle on guilty individuals involved with pharmaceutical companies, hospitals, health insurance corporations, the American Medical Association, medical schools, and all levels of U.S. government. Referring to this "network of mutually beneficial relationships" as the Medical Industrial Complex, he convincingly rails against an industry that consistently produces "outcomes that are, in general, truly dismal." The inferiority of U.S. health care compared to dozens of other nations has been well-documented for several decades, and the author effectively builds on that documentation. He demonstrates how leaders of other nations have consciously decided that quality health care is a basic right for all citizens, in large part because a healthy citizenry is essential to economic well-being. However, decades ago, American leaders decided that quality health care was not a basic right of citizenship; instead, they chose to rely on market capitalism as the health care model, with disastrous results. Magee suggests multiple sensible reforms in the realms of medical education, clinical research, publication of medical trials, marketing by pharmaceutical companies, and politically driven interactions within the MIC.

Readers will hope that Magee's knowledgeable, urgent indictment, following so many others in recent years, will lead to meaningful reforms.

Kirkus Reviews