front cover of Affirmative Action in Medicine
Affirmative Action in Medicine
Improving Health Care for Everyone
James L. Curtis, M.D.
University of Michigan Press, 2003
Affirmative action programs have significantly changed American medicine for the better, not only in medical school admissions and access to postgraduate training but also in bringing a higher quality of health care to all people. James L. Curtis approaches this important transition from historical, statistical, and personal perspectives. He tells how over the course of his medical education and career as a psychiatrist and professor--often as the first or only African American in his cohort--the status of minorities in the medical professions grew from a tiny percentage to a far more equitable representation of the American population.
Advancing arguments from his earlier book, Blacks, Medical Schools, and Society, Curtis evaluates the outcomes of affirmative action efforts over the past thirty years. He describes formidable barriers to minority access to medical-education opportunities and the resulting problems faced by minority patients in receiving medical treatment. His progress report includes a review of two thousand minority students admitted to U.S. medical schools in 1969, following them through graduation and their careers, comparing them with the careers of two thousand of their nonminority peers. These samples provide an important look at medical schools that, while heralding dramatic progress in physician education and training opportunity, indicates much room for further improvement.
A basic hurdle continues to face African Americans and other minorities who are still confined to segregated neighborhoods and inferior school systems that stifle full scholastic development. Curtis urges us as a nation to develop all our human resources through an expansion of affirmative action programs, thus improving health care for everyone.
James L. Curtis is Clinical Professor Emeritus of Psychiatry, Columbia University College of Physicians and Surgeons.
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front cover of Biobazaar
Biobazaar
The Open Source Revolution and Biotechnology
Janet Hope
Harvard University Press, 2008

Fighting disease, combating hunger, preserving the balance of life on Earth: the future of biotechnological innovation may well be the future of our planet itself. And yet the vexed state of intellectual property law—a proliferation of ever more complex rights governing research and development—is complicating this future. At a similar point in the development of information technology, “open source” software revolutionized the field, simultaneously encouraging innovation and transforming markets. The question that Janet Hope explores in Biobazaar is: can the open source approach do for biotechnology what it has done for information technology? Her book is the first sustained and systematic inquiry into the application of open source principles to the life sciences.

The appeal of the open source approach—famously likened to a “bazaar,” in contrast to the more traditional “cathedral” style of technology development—lies in its safeguarding of community access to proprietary tools without discouraging valuable commercial participation. Traversing disciplinary boundaries, Hope presents a careful analysis of intellectual property-related challenges confronting the biotechnology industry and then paints a detailed picture of “open source biotechnology” as a possible solution. With insights drawn from interviews with Nobel Prize–winning scientists and leaders of the free and open source software movement—as well as company executives, international policymakers, licensing experts, and industry analysts—her book suggests that open source biotechnology is both desirable and broadly feasible—and, in many ways, merely awaiting its moment.

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front cover of Demanding Medical Excellence
Demanding Medical Excellence
Doctors and Accountability in the Information Age
Michael L. Millenson
University of Chicago Press, 1997
Demanding Medical Excellence is a groundbreaking and accessible work that reveals how the information revolution is changing the way doctors make decisions. Michael Millenson, a three-time Pulitzer Prize nominee as a health-care reporter for the Chicago Tribune, illustrates serious flaws in contemporary medical practice and shows ways to improve care and save tens of thousands of lives.

"If you read only one book this year, read Demanding Medical Excellence. It's that good, and the revolution it describes is that important."—Health Affairs

"Millenson has done yeoman's work in amassing and understanding that avalanche of data that lies beneath most of the managed-care headlines. . . . What he finds is both important and well-explained: inconsistency, overlap, and inattention to quality measures in medical treatment cost more and are more dangerous than most cost-cutting measures. . . . [This book] elevates the healthcare debate to a new level and deserves a wide readership."—Library Journal

"An involving, human narrative explaining how we got to where we are today and what lies ahead."—Mark Taylor, Philadelphia Inquirer

"Read this book. It will entertain you, challenge, and strengthen you in your quest for better accountability in health care."—Alex R. Rodriguez, M.D., American Journal of Medical Quality

"Finally, a health-care book that doesn't wring its hands over the decline of medicine at the hands of money-grubbing corporations. . . . This is a readable account of what Millenson calls a 'quiet revolution' in health care, and his optimism makes for a refreshing change."—Publishers Weekly

"With meticulous detail, historical accuracy, and an uncommon understanding of the clinical field, Millenson documents our struggle to reach accountability."—Saty Satya-Murti, M.D., Journal of the American Medical Association

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front cover of Future Medicine
Future Medicine
Ethical Dilemmas, Regulatory Challenges, and Therapeutic Pathways to Health Care and Healing in Human Transformation
Michael H. Cohen
University of Michigan Press, 2002
Future Medicine is an investigation into the clinical, legal, ethical, and regulatory changes occurring in our health care system as a result of the developing field of Complimentary and Alternative Medicine (CAM). Here Michael H. Cohen describes the likely evolution of the legal system and the health care system at the crossroads of developments in the way human beings care for body, mind, emotions, environment, and soul.
Through the use of fascinating and relevant case studies, Cohen presents stimulating questions that will challenge academics, intellectuals, and all those interested in the future of health care. In concise, evocative strokes, the book lays the foundation for a novel synthesis of ideas from such diverse disciplines as transpersonal psychology, political philosophy, and bioethics. Providing an exploration of regulatory conundrums faced by many healing professionals, Cohen articulates the value of expanding our concept of health care regulation to consider not only goals of fraud control and quality assurance, but also health care freedom, integration of global medicine, and human transformation.
Future Medicine provides a fair-minded, illuminating, and honest discussion that will interest hospice workers, pastoral counselors, and psychotherapists, as well as bioethicists, physicians and allied health care providers, complementary and alternative medical providers (such as chiropractors, acupuncturists, naturopaths, massage therapists, homeopaths, and herbalists), and attorneys, hospital administrators, health care executives, and government health care workers.
Michael H. Cohen is Director for Legal Programs, the Center for Research and Education in Complementary and Integrative Medical Therapies, Beth Israel Deaconess Medical Center, Harvard Medical School.
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front cover of Measuring the Gains from Medical Research
Measuring the Gains from Medical Research
An Economic Approach
Edited by Kevin M. Murphy and Robert H. Topel
University of Chicago Press, 2003
In 1998, health expenditures in the United States accounted for 12.9% of national income-the highest share of income devoted to health in the developed world. The United States also spends more on medical research than any other country-in 2000, the federal government dedicated $18.4 billion to it, compared with only $3.7 billion for the entire European Union. In this book, leading health economists ask whether we are getting our money's worth.

From an economic perspective, they find, the answer is a resounding "yes": in fact, considering the extraordinary value of improvements to health, we may even be spending too little on medical research. The evidence these papers present and the conclusions they reach are both surprising and convincing: that growth in longevity since 1950 has been as valuable as growth in all other forms of consumption combined; that medical advances producing 10% reductions in mortality from cancer and heart disease alone would add roughly $10 trillion-a year's GDP-to the national wealth; or that the average new drug approved by the FDA yields benefits worth many times its cost of development.

The papers in this book are packed with these and many other surprising revelations, their sophisticated analysis persuasively demonstrating the massive economic benefits we can gain from investments in medical research. For anyone concerned about the cost and the value of such research-from policy makers to health care professionals and economists-this will be a landmark book.
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front cover of The Medical Malpractice Myth
The Medical Malpractice Myth
Tom Baker
University of Chicago Press, 2005
American health care is in crisis because of exploding medical malpractice litigation. Insurance premiums for doctors and malpractice lawsuits are skyrocketing, rendering doctors both afraid and unable to afford to continue to practice medicine. Undeserving victims sue at the drop of a hat, egged on by greedy lawyers, and receive eye-popping awards that insurance companies, hospitals, and doctors themselves struggle to pay. The plaintiffs and lawyers always win; doctors, and the nonlitigious, always lose; and affordable health care is the real victim.

This, according to Tom Baker, is the myth of medical malpractice, and as a reality check he offers The Medical Malpractice Myth, a stunning dismantling of this familiar, but inaccurate, picture of the health care industry. Are there too many medical malpractice suits? No, according to Baker; there is actually a great deal more medical malpractice, with only a fraction of the cases ever seeing the inside of a courtroom. Is too much litigation to blame for the malpractice insurance crisis? No, for that we can look to financial trends and competitive behavior in the insurance industry. Are these lawsuits frivolous? Very rarely. Point by point, Baker—a leading authority on insurance and law—pulls together the research that demolishes the myths that have taken hold about medical malpractice and suggests a series of legal reforms that would help doctors manage malpractice insurance while also improving patient safety and medical accountability.

President Bush has made medical malpractice reform a priority in his last term in office, but if history is any indication, legislative reform would only worsen the situation and perpetuate the gross misunderstanding of it. The debate surely will be transformed by The Medical Malpractice Myth, a book aimed squarely at general readers but with radical conclusions that speak to the highest level of domestic policymaking.
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front cover of The Political Economy of Health in Africa
The Political Economy of Health in Africa
Mis Af#60
Toyin Falola
Ohio University Press, 1992
This book examines the major phases in the history of health services in Africa and treats health as an integral aspect of the deepening crisis in Africa’s underdevelopment. One important thesis is that Western delivery systems have made health care less accessible for most people. Contributors direct attention to problems engendered by food shortages, acute cases of infection, the market in fake drugs as well as the inequality of access to facilities, the violation of human rights, and the recent danger of the dumping of toxic wastes in several African countries. One major implication of this volume is that there can be no solution to the health crisis in Africa until the linkage between health and poverty is recognized. The authors consider questions that add to the contemporary discussion of the place that traditional African medicine and philosophy should take alongside modern Western medicine in Africa today.
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front cover of Technological Change in Health Care
Technological Change in Health Care
A Global Analysis of Heart Attack
Mark B. McClellan and Daniel P. Kessler, Editors
University of Michigan Press, 2002
Evidence from the United States suggests that technological change is a key factor in understanding both medical expenditure growth and recent dramatic improvements in the health of people with serious illnesses. Yet little international research has examined how the causes and consequences of technological change in health care differ worldwide. Seeking to illuminate these issues, this volume documents how use of high-technology treatments for heart attack changed in fifteen developed countries over the 1980s and 1990s. Drawn from the collaborative effort of seventeen research teams in fifteen countries, it provides a cross-country analysis of microdata that illuminates the relationships between public policies toward health care, technology, costs, and health outcomes.
The comparisons presented here confirm that the use of medical technology in treatment for heart attack is strongly related to incentives, and that technological change is an important cause of medical expenditure growth in all developed countries. Each participating research team reviewed the economic and regulatory incentives provided by their country's health system, and major changes in those incentives over the 1980s and 1990s, according to a commonly used framework. Such incentives include: the magnitude of out-of-pocket costs to patients, the generosity of reimbursement to physicians and hospitals, regulation of the use of new technologies or the supply of physicians, regulation of competition, and the structure of hospital ownership. Each team also reviewed how care for heart attacks has changed in their country over the past decade.
The book will be of enormous importance to health economists, medical researchers and epidemiologists, and policymakers.
Mark McClellan is Associate Professor of Economics and of Medicine and, by courtesy, of Health Research and Policy, Stanford University. He is a National Fellow, the Hoover Institution. Daniel P. Kessler is Associate Professor of Economics, Law, and Policy in the Graduate School of Business, Stanford University, and a Research Fellow, the Hoover Institution.
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