Product Description

Product Details

• Amazon Sales Rank: #195759 in Books
• Published on: 2007-09-18
• Released on: 2007-09-18
• Original language: English
• Number of items: 1
• Binding: Hardcover
• 352 pages

From Publishers Weekly
Starred Review. Contrary to Americans' common belief that in health care more is more—that more spending, drugs and technology means better care—this lucid report posits that less is actually better. Medical journalist Brownlee acknowledges that state-of-the-art medicine can improve care and save lives. But technology and drugs are misused and overused, she argues, citing a 2003 study of one million Medicare recipients, published in the Annals of Internal Medicine, which showed that patients in hospitals that spent the most were 2% to 6% more likely to die than patients in hospitals that spent the least. Additionally, she says, billions per year are spent on unnecessary tests and drugs and on specialists who are rewarded more for some procedures than for more appropriate ones. The solution, Brownlee writes, already exists: the Veterans Health Administration outperforms the rest of the American health care system on multiple measures of quality. The main obstacle to replicating this model nationwide, according to the author, is a powerful cartel of organizations, from hospitals to drug companies, that stand to lose in such a system. Many of Brownlee's points have been much covered, but her incisiveness and proposed solution can add to the health care debate heated up by the release of Michael Moore's Sicko. (Sept.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From Booklist
*Starred Review* Award-winning health and medicine writer Brownlee notes that Americans spend between one-fifth and one-third of health-care dollars on unnecessary treatments, medications, devices, and tests. What's worse, there are an estimated 30,000 deaths per annum caused by this unnecessary care. The reason for what amounts to a national delusion that more care is better care is rooted, she says, in a build-it-and-they-will-come paradigm that rewards doctors and hospitals for how much care they deliver rather than how effective it is. In a step-by-step deconstruction of America's improvident health-care system, Brownlee sheds light on events, attitudes, and legislation in the twentieth century's latter half that led to this economic nightmare. With the skill of a crack prosecuting attorney, she cites specific cases of physician and hospital fiscal abuse. Her aim is broad but not scattershot as she hits not just docs and hospitals but private insurers, Medicare, patients, medical device manufacturers, and pharmaceutical companies by, for instance, quoting a pharmaceutical salesperson who confesses financing a physician's swimming pool to get the doc to write more prescriptions. She is not all bad news, though, for she posits models that could be adapted to create a nationwide health-care system that conceivably could staunch the current fiscal hemorrhaging. If only. Chavez, Donna

Review
PRAISE FOR OVERTREATED: "My choice for the economics book of the year...it's the best description I have yet read of a huge economic problem that we know how to solve--but so often misunderstood."—New York Times article 'No. 1 Book, and It Offers Solutions' “This book is written for a sophisticated general audience. I hope it is widely read, providing patients with the needed resolve to stop demanding that their physicians prescribe the latest procedure, poultice or potion that marketing and medical journalism foists on them….Brownlee’s presentation is brilliant journalism.”—Journal of the American Medical Association “The cardiologist who found blocked arteries in nearly every patient…the brilliant breast cancer cure that too often killed patients…Brownlee uses anecdotes of medical misdeeds, mistakes, and misunderstandings to illustrate a surprising truth at the heart of American healthcare: More isn’t necessarily better. Shoring up her conclusions with groundbreaking findings from a group of researchers at Dartmouth, Brownlee also points the way to workable solutions.”—O Magazine "Excellent new book"—Slate.com “A bombshell of a book: must reading for consumers, their political representatives and all those White House contenders.”—Kirkus, Starred review
 
“[Brownlee] presents a stunning but reasoned picture of the out-of-control, inefficient and often tragically ineffective U.S. health care system…This rousing call for change, accessible for general readers, is recommended.”— Library Journal
 “Exhaustive takedown of the U.S. health-care system…Overtreated eclipses Michael Moore’s reporting and eschews his polemics. By piling on facts, Brownlee shows why Americans spend so much on health care yet are in measurably poorer shape than the residents of just about every other developed nation."—Conde Nast Portfolio “alarming and intriguing…Brownlee gives each of her theme-based chapters an emotional core by rolling out a story.”—Bloomberg.com “’Overtreated’ should be read by anyone interested in health care economics.”—Tyler Cowen, Marginalrevolution.com  "Overtreated is a marvelous new book by Shannon Brownlee.”—Thehealthcareblog.com “Finally, someone willing to expose the dirty little secret of US health care. If you have insurance you will certainly get too much health care, and in this situation more is definitely not better. Shannon Brownlee's book, Overtreated, will open your eyes to the problems and point the way to the answers.”—Susan Love, M.D., author of Dr. Susan Love's Breast Book, President and Medical Director, Dr. Susan Love Research Foundation “In the blizzard of books on our healthcare system, Shannon Brownlee’s is unique in its provocative argument that individuals and the nation suffer from misguided and costly treatments. Patients, physicians, and policy makers would do well to consider her evidence as an important prescription for reform.”—Jerome Groopman, M.D., Harvard Medical School and author of How Doctors Think  "This book could save your life.  In gripping detail, Shannon Brownlee explains how well-insured Americans get much more high-tech medical care -- CT scans, angiograms, and the like -- than they need, enriching the hospitals and doctors who provide it, but driving up the overall costs of health care and often endangering patients' lives.  Brownlee clearly shows in this important book that overtreatment, like undertreatment, is very bad medicine.”—Marcia Angell, senior lecturer in social medicine at Harvard Medical School and former editor-in-chief of the New England Journal of Medicine  “Overtreated will scare you. And that's a good thing. In this vivid and arresting tour of medicine in America, Shannon Brownlee shows why the care that is supposed to make us healthier frequently makes us sicker instead. At a time when health care reform is atop the political agenda again, this book should be required reading -- not only for every lawmaker and medical professional, but for every voter and patient, too.”—Jonathan Cohn, author of Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price “With her razor-sharp analyses, Shannon Brownlee disentangles the messy paradoxes of today's health care mess and turns every assumption on its head. She will forever change the way you view health care while restoring your hope for its future. This book is an important read for anyone interested in health care reform, which, in this day and age of overtreatment, should be all of us.”—Pauline Chen, author of Final Exam: A Surgeon's Reflections on Mortality "Overtreated is a necessary, if bitter tonic. As the election season starts to take shape, we desperately need an unbiased examination of the mess we're in and some substantiative ideas for fixing it. Overtreated delivers on both counts...Brownlee uncovers some truly amazing facts...Brownlee has given us a thoughtful push in the right direction."--Cleveland Plain Dealer

Customer Reviews

Excellent book!
This is an excellent book detailing how pharmaceutical companies have fostered over-medication on the public in the name of profits.

Root cause for spiraling health care costs in the US
This country has spent a lot of time agonizing over health care delivery and costs ever since medicare was introduced in the 1960's. Since then, health care costs have increased at rates much higher than inflation causing health care to become unaffordable to many people and a huge economic burden on US businesses that must supply health care insurance to their employees. The way things are headed, Medicare will soon be insolvent (it's a much bigger problem than social security) and even more people will be uninsured.

Against the clatter of partisan politics and special interest obfuscation, this book prevents a well-researched, evidence-based discussion of one the main driving factors behind the perverse economics of health care. Until people and politicians understand the root causes of the problem, the problem can't be solved. I hope people read this book because it's a big step forward towards a solution.

Healthcare System Misdiagnosis
The author clearly documents how our healthcare system frequently wastes resources on unnecessary scans and procedures due to a number of reasons including, demands of the patient, doctor's personal beliefs in a procedure, and the economic incentive of more procedures resulting in more profit.

From the author's perspective, over treatment is the problem and the solution is better assessments of what scans and treatments are needed, part of which includes communication between the doctor and patient. When the patient understands and can weigh the potential risks and benefits, he or she is likely to be more conservative than the doctor, resulting in less care by direction of the patient.

What the author overlooks is the patient's lack of consideration of cost. In nearly any other transaction in our economy, the customer would not only evaluate risk and benefit but also cost. Over treatment is not the core problem, but a symptom of the problem. The problem is our healthcare system is a big all you can eat buffet where your personal consumption has little or no impact on your cost. As the community eats more and more, the buffet price goes up for everyone. Meanwhile the cooks are profit motivated for you to eat more. The expensive dishes are being promoted while the cheaper ones may not even be displayed unless you ask for them by name.

Pharmaceutical companies, medical device manufacturers, hospitals and physicians need to have the same market pressures that nearly every other business has, that their product or service be affordable to their customer and it's benefits outweigh it's cost, otherwise there will be no sale and thus no profit. Insurance works against this basic virtue of the free market. A system that gives the customer an incentive to shop and consider costs, such as HSA's, is what is truly missing from America's healthcare system. Over treatment is merely a symptom of the underlying problem.