The Price We Pay by Marty Makary

THE PRICE WE PAY by Marty Makary is subtitled “What Broke American Health Care—and How to Fix It.” Makary has long been concerned with health care costs and helping consumers to be more knowledgeable. He is a best-selling author (Unaccountable, 2012), surgeon, and a professor of Health Policy at the Johns Hopkins School of Public Health. In THE PRICE WE PAY, Makary divides his chapters into three broad sections titled Gold Rush, Improving Wisely, and Redesigning Health Care. In the first, he looks at issues like “Two Americas” where he describes situations for individual patients such as the horrific one for Jennifer and her husband, young parents from Carlsbad, New Mexico where the hospital repeatedly sued them for non-payment and then garnished wages even though many of the costs were associated with an infection caused by the hospital itself. He also profiles Mary Washington Hospital, serving a community of about 25,000 in Fredericksburg, Virginia; over the last five years, that hospital has filed 24,200 lawsuits! He and his team documented the pattern wherein American workers (especially those in retail like Walmart, Lowe’s, Kroger, etc.) with health insurance “made too little money to afford inflated hospital bills but made too much to qualify for Medicaid.”

In the second section of THE PRICE WE PAY, Makary focuses on specific issues like unnecessary C-sections for women in labor or overtreatment with drug prescriptions and devotes one chapter to the opioid epidemic. Finally, he uses the last section of his book to explore disruption in the industry, to look more specifically at health insurance, and to offer a concluding call to action and more transparency in the face of price gouging and “ugly” billing procedures. Although Makary does an excellent job of outlining issues and abuses, his proposed solution seems to rely mostly on medical doctors policing a system that will be hard to change. THE PRICE WE PAY contains several pages of notes and an index; this new title received a starred review from Booklist.

The Rabbit Effect by Kelli Harding

THE RABBIT EFFECT by Kelli Harding describes how to “Live Longer, Happier, and Healthier with the Groundbreaking Science of Kindness.” Harding, an assistant professor of psychiatry at Columbia University Medical Center and emergency room doctor, sought to explore the question: “What are we missing in medicine that’s crucial to health?” and was inspired to write this book by a 1978 study which showed that rabbits who were treated more kindly by attendants had better health outcomes, despite being fed the same high-fat diet as others. Harding traces work that supports the holistic view that “a person’s health occurs in a social context that cannot be ignored” and argues that “two halves [medicine and public health] needed unification with a common language” since “the vast majority, 80 to 90 percent, of people’s health depends on factors outside clinical care.” Her book spends several chapters discussing hidden factors (for example, in our intimate relationships, our work, our education and neighborhoods) as well as the essentials of health, both individually and collectively. In a very accessible style, Harding recounts numerous scientific experiments and other anecdotes; raising questions (e.g., if genetics are fixed, why was love changing personality?) and offering “toolkit” suggestions for action by her readers. Although THE RABBIT EFFECT has no index, Harding does include almost 30 pages of source notes. This encouraging text will be of interest to AP Psych classes, perhaps to some of our anatomy students, and also relevant to this year’s professional development on social emotional learning, especially in conjunction with other titles like The War for Kindness or The Telomere Effect.