Tuesday, September 25, 2012

Book Review: Scott W. Atlas, MD,  In Excellent Health: Setting the Record Straight on America's Health Care, Hoover Institution Press, 2011, 359 pages, hardcover, $26
To my father, who often joked, “My mind’s made ‘s made up, don’t confuse me with facts.
Dedication by Scott Atlas, MD,  Author of In Excellent Health,  Hoover University Press, 2011

September 25, 2012 -  This is a must read for defenders of the U.S. health system.  As such, it is rare. Most books on health reform attack the U.S. as too costly with poor results compared to other developed Western nations with nationalized universal coverage.  
The author, a professor of radiology at Stanford and head of the Neuroradiology Department at Stanford,  begins his book with this anecdote.
In the summer of 2007, he attended a dinner party with six adults.  All had  undergraduate degrees from prestigious undergraduate university as well as postgraduate degrees from Princeton, the University of Chicago and Stanford. 
Four had MD degrees, one held a PhD in molecular biology, and another had a master degree in Public Health.  Four  were practicing physicians. All agreed with the thesis of  Michael  Moore’s film  Sicko!. Moore argued the U.S. health system was inferior to that of Cuba and other socialist and communist nations.  None of the party-goers had seen the film. They took  for granted Moore  spoke some Great Truth, that the American’s capitalist, market-driven,  greed-based system, was inferior to government-directed systems.
The discussion shocked Dr. Atlas and his wife, who had seen the Moore film, and Atlas  decided to write this fact-based book as a counter to  blind liberal bias.
His first chapter is a critical appraisal of the 2000 WHO ranking of health systems, which placed the U.S. as 37th among nations in its health system.  He systematically demolishes the study as deeply flawed, agenda-driven, and subjective without basis in fact, unrelated to actual health system quality.

The WHO ranking served as the pretext for Obamacare, which said, in essence, that the U.S.spends twice as much on health care as any other nations, achieves less in terms of longevity and infant mortality, and is unfair.
In subsequent chapters – limited vale of live expectancy comparisons,  limits of infant mortality at indicator of heath care, measures of medical quality, Americans' access  to health care,  the important of specialists and medical innovation, and solutions to maintaining excellence of the American sysem , Doctor Atlas demolishes the argument the U.S. has an inferior system.
Atlas  points out,  for example,  that health statistics on longevity and infant mortality are flawed and are based on a  nation’s culture and  individual behavior of its citizens.  if one takes into consideration such factors as obesity and smoking, which are beyond the control of the health system;  if one eliminates murders and automobile deaths from  the statistics, the U.S. ranks number one in longevity. 
Furthemore, if one considers waits for treatment, access to doctors,  number of Nobel Prize winners,  and superior results in cancer outcomes,  joint replacement, hypertension, heart disease, diabetes, we are the world’s best.  
Atlas backs up these facts with numerous bar graphs and tables to buttress his argument that the U.S. has the best health systems in the world with the best results. Atlas ends his book with his suggestions for health reform – increased competition in insurance and health care markets, consumer-drive cae,  value-based purchasing, and minimal government intervention.
Tweet:  Scott Atlas’ book In Excellent Health :Setting the Record Straight on America’s Health Care, says that America has an exceptional  health system compared to other nations.

No comments: