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Medical Writings |6 May 2008

A Second Opinion: Rescuing America's Health Care

Robert J. Caswell, PhD

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Author, Article, and Disclosure Information
  • From Ohio State University College of Public Health, Columbus, Ohio.

Structured abstracts of information on newly published books, computer programs, selected Web sites, and other material are provided in this portion of Medical Writings.
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Structured abstracts of information on newly published books, computer programs, selected Web sites, and other material are provided in this portion of Medical Writings.
A Second Opinion: Rescuing America's Health Care
Relman AS. 224 pages. New York: PublicAffairs; 2007. $24.00. ISBN 9781586484811. Order at www.publicaffairsbooks.com.
Field of medicine: Health policy and management.
Format: Hardcover book.
Audience: Anyone interested in health policy and health reform, especially those in the medical profession.
Purpose: To provide “a ‘second opinion’ about the state of our health care system and the major reforms it requires. It is in essence a personal manifesto.”
Content: This brief book presents the author's analysis of the principal causes of the current crisis in the U.S. health care system and his recommended solution. He begins with a recapitulation of the argument from his landmark 1980 article identifying the “medical industrial complex” and the “commercialization” of medicine and health care. He then describes the forces leading to the escalating problems of cost containment and the failure of managed care to rescue payers from these cost pressures. After setting the stage to consider remedies, he recommends the creation of a single-payer financing system that retains a private delivery system built around multispecialty group practices and private nonprofit institutional providers. He includes a chapter examining problems in the Canadian system, which is the system most similar to his proposal. The book concludes with an “open letter” to the U.S. medical professional community, urging physicians to take an active role in health reform,...
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Caswell RJ. A Second Opinion: Rescuing America's Health Care. Ann Intern Med. 2008;148:716. doi: https://doi.org/10.7326/0003-4819-148-9-200805060-00026

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Published: Ann Intern Med. 2008;148(9):716.

DOI: 10.7326/0003-4819-148-9-200805060-00026

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2008 American College of Physicians
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