Monday, April 8, 2013

Book Review: Fractured

Here are a few excerpts from my less-than-enthusiastic review of Fractured: America's Broken Health Care System and What We Must Do To Heal It, by Dr. Ted Epperly, which appears in the April 2013 issue of Family Medicine.

The book’s chapters on historical health reform efforts in the United States and comparisons to the health care systems of other countries are two of the most lucid that I’ve read. Entire volumes have been written on each of these topics, which the author manages to boil down to just over 50 pages of succinct text supported by a series of informative tables and figures. In one particularly strong passage, the book explains how the United States is effectively divided into the imaginary countries of “Richland” and “Poorland,” separated not only by enormous gaps in income but also life expectancy, out-of-pocket health spending, and access to primary and specialty care services.

By comparison, the chapter that explains “why America struggles with health care for all” is a confusing recitation of pro-ACA talking points. ... After assuring readers in the first chapter that his goal “is not to take one political side or another,” the author then proceeds to do exactly that. ... Aside from a passing mention in the first chapter, the book provides no sense of Dr Epperly’s presumably positive experiences as a military physician. A few representative patient anecdotes could have gone a long way toward distinguishing Fractured from the ever expanding library of tomes written by health policy wonks without the clinical experience of a family physician. As the director of a health policy fellowship program for family physicians, I would be unlikely to include this book on a required reading list.

You can also go to the Family Medicine website to read the full review.