Big Med

There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet. Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms. In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised. This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.

Many Americans believe that their healthcare is second to none. Most patients, therefore, fail to appreciate the flaws and dangers present while receiving medical care. In fact, the American health care industry is one of the great tragedies of this country, which is now being brought to its knees by the medical industry run amuck. The Truth About Big Medicine: Righting the Wrongs for Better Health Care divulges secrets of the industry, which keep it focused on its own economic needs to the detriment of public health. The cost of American health care per person far exceeds other developed countries, yet it delivers life expectancies and infant mortalities that are shamefully ranked low among developed nations. Special interest groups and weak legislation created a “tapeworm” that continues to devour the American economy and shorten the lives of hundreds of thousands each year. Using true stories throughout, the authors illustrate that it is time for the public, students, educators, and legislators to clearly recognize medical deception and secrecy and to consider clear solutions on how they can achieve a safer health care system. A rich variety of authors with experience in revealing unsafe medical practices bring recommendations for changing health care delivery by taking an aspect of the health care system, identifying its shortcomings, and proposing ways to reduce harm plus correct the injustices. Included are discussions of imaging, medical devices, pharmaceuticals, hospital practices and procedures, and medical malpractice and negligence, among other topics. No consumer of health care should ignore the dangers; this book helps reveal them and suggests useful remedies. The authors maintain a website at http://truthaboutbigmedicine.com/

List of members in vol. 1-17 and occasional other volumes.

This book constitutes the refereed proceedings of the 19th International Conference on Embedded Computer Systems: Architectures, Modeling, and Simulation, SAMOS 2019, held in Pythagorion, Samos, Greece, in July 2019. The 21 regular papers presented were carefully reviewed and selected from 55 submissions. The papers are organized in topical sections on system design space exploration; deep learning optimization; system security; multi/many-core scheduling; system energy and heat management; many-core communication; and electronic system-level design and verification. In addition there are 13 papers from three special sessions which were organized on topics of current interest: insights from negative results; machine learning implementations; and European projects.

Patients and doctors alike are keenly aware that the medical world is in the midst of great change. We live in an era of continuous healthcare reforms, many of which focus on high volume, efficiency, and cost-effectiveness. This compelling, thoughtful book is the response of a practicing psychiatrist who explains how population-based reforms have diminished the relationship between doctors and patients, to the detriment of both. As an antidote to failed reforms and an alternative to stubbornly held traditions, Dr. Abraham M. Nussbaum suggests ways that doctors and patients can learn what it means to be ill and to seek medical assistance. Using a variety of riveting stories from his own and others’ experiences, the author develops a series of metaphors to explore a doctor’s role in different healthcare reform scenarios: scientist, technician, author, gardener, teacher, servant, and witness. Each role influences what a physician sees when examining a person as a patient. Dr. Nussbaum cautions that true healthcare reform can happen only when those who practice medicine can see, and be seen by, their patients as fellow creatures. His memoir makes a hopeful appeal for change, and his insights reveal the direction that change must take.

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