Well written, this book is hard to read: it is tells compelling histories of health care gone wrong, analyzes root causes and is very well referenced. It authoritatively recounts the tortuous path of all of the important health care sectors* that have led us to fractured, inefficient, costly, wasteful and dangerous "health" care.
Magee's book was also hard to read on a personal level: I am a retired physician - an infectious disease specialist in private practice in community hospitals for 26 years in Los Angeles and for 10 years was the chief medical officer for 2 community hospitals, one in LA and one in San Francisco. As chief medical officer, I oversaw quality improvement, risk management and medical staff governance. I look back on my career and my colleagues - we have been pawns and unwittingly manipulated.
Magee's book powerfully shows how the work of countless principled, well-meaning, dedicated health care professionals over the ages has been impaired, stymied and continuously out maneuvered. The medical-industrial complex has taken advantage of and preyed upon these professionals, too often "guilting" them or taking advantage of their moral/ethical commitment to provide "care”.
This book is a call to action - a must read for every presidential candidate, senator, congressman, governor and legislator - and their staffs/advisors. These officials will be the ones who must pass effective legislation for the benefit of all people. Magee's last chapter offers basic steps to reform the MIC regarding medical education, research, publications and marketing. He cites 10 reasons to consolidate oversight to a single centralized authority. This is all good foundationally, but the politicians with principled, knowledgeable health care experts must structurally re-build our health care system not just to fight disease, but to improve health and well-being.
*PhRMA, physicians, hospitals, health care systems, research, regulatory oversight, insurance, education of medical/health care professionals, pharmacy benefit management
Having been a sales rep (Detail Man) for 30 years, I have seen it all. However, Code Blue opened my eyes to how I was played by the Companies I represented. I am too young for Medicare but too " Old" to carry a bag anymore so I pay my own Healthcare coverage. Obamacare had been in the works long before President Obama was even born. The middle class was caught flat footed when it passed, thus making ends meet meant no more expensive vacations or new cars every other year. I didn't realize how the Medical Industrial Complex wielded so much political power to keep American's healthcare in the private sector. Dr. Magee's well referenced book (I did go down many rabbit holes in the footnotes to see how his point was derived) is easy to read. He lays it out, where we came from, how we got here, and how to make it better. Greed however is the main topic or should I say "elephant in the room." Code Blue in the hospital setting is a call to action....and that's what we as consumers of healthcare need to do with Dr. Magee's message. Spread the word!
Reading Code Blue by Dr. Mike Magee felt like I was taking a graduate school class in the history of modern medicine while also being gifted a behind the scenes pass at what is really happening in the pharmaceutical industry and its ties to politics, lobbyists and the Medical Industrial Complex that seems to be benefitting everyone except us as patients.
This is a must read book for all Americans who want to understand how we became a nation with one of the worst healthcare systems and one of the sickest nations.
Take note current and future leaders on both a state and national level- Dr. Mike Magee gives you the play by play for how to fix this mess.
It is not too late to become the United States all people deserve us to be.
Awesome book detailing how we got to where we are in health care. Japan and Getmany are rated the best in health care. Disney realize that was after Marshall Plan helped them formulate national health care. Our vanquished enemies. Plan was to be same in US but never passed those who had profit motive foremost I. Health. Informative and at same time disturbing. Read it and think!
Mike Magee has taken the lightning rod issue of healthcare reform in this country and examined the problems created by what he terms the Medical Industrial Complex (MIC). He describes the enmeshed relationships that exist among, hospitals, insurance companies, and pharmaceutical companies. Added to that are the intertwined interests of academic institutions, advocacy groups, and the American Medical Association (AMA) which have all served to create a nightmare for regulators and sent healthcare costs soaring.
Dr. Magee is in a prime position to provide an overall review of the subject as he has been a practicing urologist, a senior executive in a major hospital system, an academician in medical schools, and the head of global affairs for Pfizer pharmaceuticals. What he has done in this manifesto is to reveal how we arrived at where we are today, how and why these afore-mentioned institutions became entangled. The book is a part history lesson, part expose and part proposal of the direction forward.
The history of the various medical entities such as the AMA, National Institute of Health (NIH), FDA, Medicare, HMOs, Pharmacy Benefit Managers (PBMs) and Centralized Research Organizations (CROs) is presented along with how these players have impacted healthcare. This may sound like dry reading. It isn’t. To illustrate how our current system has evolved, Magee describes some of the medical tragedies that have affected the development of the current regulatory system. He covers:
• the Massengill tragedy in 1937 where children died after being given a liquid version of sulfanilamide (an antibiotic) used to treat strep throat. The liquid version contained a chemical used in brake fluid.
• the use of the sedative thalidomide. Children exposed to the drug in utero developed deformities.
• the Tuskegee experiment that exposed African-American veterans to syphilis without their knowledge and left them untreated.
• the promotion of cigarettes to doctors by tobacco companies in the 1950s for physician use as a stress reliever.
• the promotion of the ADHD diagnosis in children, an example of drug companies creating a market for a product.
• the slow reaction of the MIC to the AIDS epidemic.
• the Nigerian tragedy where children diagnosed with meningitis were treated with a powerful antibiotic causing deaths as many of the children were too underweight and immunocompromised to withstand treatment.
• the opioid crisis as an outcome of pharmaceutical company promotion of an addictive drug.
In the final pages, Magee lists proposals which should be taken seriously by people no matter what their political affiliation. The work is well-written, understandable and offers an expert’s opinion on what is needed to resolve the health care mess we’re in. The book will probably anger some. You don’t have to agree with the general solutions he presents to benefit from his insight and knowledge. This is a must-read book for those wanting to educate themselves on the issue.
Code Blue should be required reading for all, not just those who are concerned with the soaring cost of health care in this country along with the epidemic of unhealthy people who depend on it. Author Mike Magee, MD has creds. He was once on the short list to become Surgeon General of the US. Almost the first big blockbuster point he makes in this book is that the Health Care Lobby operates on 4x the funding as the Defense Lobby. Let that sink in.
Another interesting factoid (though not in itself incriminating) is that the symbol of the public health service is the Caduceus, twisted snakes wrapped around a rod is also the patron symbol for liars and thieves. How Freudian. Code Blue follows the blurred lines between physicians, hospitals, drug companies, researchers and the political influence of all. As the book progresses Magee tosses in government regulations, insurance companies, aggressive marketing, expansion oriented hospital chains, tobacco companies, religious zealots, and non-profit advocacy groups that all have their hand in the problem. The bottom line is that to stay alive the patient must pay the price.
Mcgee addresses the horrible situations that we’ve all seen on the news like the deplorable conditions found in the drug compounding centers that caused meningitis and the deaths of 64 people. We learn that the FDA tries of oversee an unfathomable array of commodities. From food safety, sperm donations, tobacco products, dietary supplements, prescriptions, OTC drugs, vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic-radiation devices, cosmetics and animal feed are all under their purview. The FDA oversees a trillion dollars in consumer spending on a rather small budget in comparison and with the big guns working against them.
The Medical Industrial Complex in the words of Yale Law School professor, Daniel Markovits, have turned America’s meritocracy into a “modern day aristocracy”. And we’re just getting started. This book, though complex, is written for the lay reader. If you’re like me it arms you with good information that you can go to your senators and congressmen with demanding a better use of your tax dollars. As I said at the beginning – this is a Must Read.
A detailed, and damning, look at what Dr. Magee calls the Medical-Industrial Complex, the manufacturing, marketing and lobbying groups that, through the 20th Century and into the 21st, made American medicine into the expensive monster that it is today, albeit delivering lower life expectancy than much of the developed world. We learn, indeed, that it is a drag on American prosperity, "the tapeworm of American economic competitiveness" with its expenses and cost-ineffectivity.
There's more, however, and Dr. Magee shows us some of the more egregious examples: the early trend of aggressive marketing by pharmaceutical companies, who deployed legions of salesmen to doctors' offices with incentives and free samples when the drugs' damaging (or sometimes lethal) side-effects were not fully known, as well as more marketing by groups like the AMA against government efforts like national health care in Truman's day, and against Medicare a generation later. We see the culture of "big ticket research and development" instead of a combined health plan, and the institutional distortions at agencies like the National Institutes of Health. We see the use of medical research as a screen for the tobacco industry.
The book, more and more, focuses on abuses in pharmaceuticals, since medicine is often pill-driven. The appearance of ADHD as a known syndrome would prompt hyping of drugs such as benzedrine, and, later, Ritalin and Adderall as over-used, and profitable, cure-all nostrums.
The book is especially timely now (spring 2019) with a major new lawsuit against Purdue Pharmaceuticals and the Sackler family. Dr. Magee shows how much industry lobbying and hype overall had contributed to the opioid epidemic, one that would leave a trail of addiction and thousands of deaths. Dr. Magee also talks about the offshoring of unproven or untested therapies and drugs in Third-world countries like Nigeria, a situation hinted at in the book and film "The Constant Gardener." He also tells of the promotional and institutional changes wrought by the Viagra marketing craze.
There's more: the encroachment of "faith based" health policy, notably during the HIV/AIDS epidemic and a convenient alliance between AIDS activists and pharmaceuticals to rush drug treatments. We see more religious opposition in fields like stem cell research.
Finally, we learn of some surprising alliances between advocacy groups and the industry, first in pushing Medicare Part D, and later, Obamacare.
It's a sordid, infuriating and illuminating work by a physician who had worked in hospital administration, and then in a senior position at Pfizer. And it's timely. Highest recommendation.
CODE BLUE is exciting, a potential blockbuster. It strongly resembles "Silent Spring" by Rachel Carson which galvanized public opinion regarding gross abuses by the chemical industry that in turn motivated Washington into revolutionizing policy. In short, it changed the world. Some would say, it saved the world. But Carson’s book more or less came out the blue. With Mike Magee's book the timing could not be better; the pump is already primed; the canon is ready to explode. With the issues of the Medical Industrial Complex and health care, the public and Congress are not nascent. They remain topics both current and of extraordinary interest that affect the health care - the lives - of 350 million Americans.
Magee's writing style is gifted. Like Carson’s - no, better than Carson’s - I see it reaching high numbers of readers in three vital and distinct categories: 1. The ordinary public: The writing is clear and straightforward. It can be understood by the man on the street. It is intelligent with no hint of any dumbing down. 2. Medical and pharmaceutical industry professionals: These include insiders on both sides of the fence. The author's style is sharp enough to engage the honest, well-meaning practitioners caught in the system. At the same time it is direct and biting enough to expose (and enrage) the abusers. 3. Legislators: I see this book also inspiring those in DC who ultimately have the power to impact public policy. One might argue that so far our representatives have not demonstrated sufficient gumption. From another point of view, I can see how CODE BLUE may very well provide the necessary motivation.