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Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer Hardcover – September 18, 2007

4.4 out of 5 stars 78 customer reviews

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Editorial Reviews

From Publishers Weekly

Starred Review. Contrary to Americans' common belief that in health care more is more—that more spending, drugs and technology means better care—this lucid report posits that less is actually better. Medical journalist Brownlee acknowledges that state-of-the-art medicine can improve care and save lives. But technology and drugs are misused and overused, she argues, citing a 2003 study of one million Medicare recipients, published in the Annals of Internal Medicine, which showed that patients in hospitals that spent the most were 2% to 6% more likely to die than patients in hospitals that spent the least. Additionally, she says, billions per year are spent on unnecessary tests and drugs and on specialists who are rewarded more for some procedures than for more appropriate ones. The solution, Brownlee writes, already exists: the Veterans Health Administration outperforms the rest of the American health care system on multiple measures of quality. The main obstacle to replicating this model nationwide, according to the author, is a powerful cartel of organizations, from hospitals to drug companies, that stand to lose in such a system. Many of Brownlee's points have been much covered, but her incisiveness and proposed solution can add to the health care debate heated up by the release of Michael Moore's Sicko. (Sept.)
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From Booklist

*Starred Review* Award-winning health and medicine writer Brownlee notes that Americans spend between one-fifth and one-third of health-care dollars on unnecessary treatments, medications, devices, and tests. What's worse, there are an estimated 30,000 deaths per annum caused by this unnecessary care. The reason for what amounts to a national delusion that more care is better care is rooted, she says, in a build-it-and-they-will-come paradigm that rewards doctors and hospitals for how much care they deliver rather than how effective it is. In a step-by-step deconstruction of America's improvident health-care system, Brownlee sheds light on events, attitudes, and legislation in the twentieth century's latter half that led to this economic nightmare. With the skill of a crack prosecuting attorney, she cites specific cases of physician and hospital fiscal abuse. Her aim is broad but not scattershot as she hits not just docs and hospitals but private insurers, Medicare, patients, medical device manufacturers, and pharmaceutical companies by, for instance, quoting a pharmaceutical salesperson who confesses financing a physician's swimming pool to get the doc to write more prescriptions. She is not all bad news, though, for she posits models that could be adapted to create a nationwide health-care system that conceivably could staunch the current fiscal hemorrhaging. If only. Chavez, Donna

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Product Details

  • Hardcover: 352 pages
  • Publisher: Bloomsbury USA; 1 edition (September 18, 2007)
  • Language: English
  • ISBN-10: 1582345805
  • ISBN-13: 978-1582345802
  • Product Dimensions: 5.9 x 1.2 x 10 inches
  • Shipping Weight: 1.2 pounds
  • Average Customer Review: 4.4 out of 5 stars  See all reviews (78 customer reviews)
  • Amazon Best Sellers Rank: #620,482 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Mark W. Ketterer on March 5, 2008
Format: Hardcover Verified Purchase
Read this book.

If you are in the American healthcare system, this is the single most important book you will ever read. If you are in a healthcare system that is moving towards "privatization" or "free market reform", this may be the most important book you will ever read. If you are a behavioral scientist interested in the role of behavioral factors in medical populations, this is the most important book you will ever read.

A science journalist with a real science background (an M.S. in Biology) and now a Fellow at the New America Foundation, Brownlee has brought together many strands of research to provide us with a picture of the core dilemma in the american health care system - why do we spend so much more than other industrialized countries while not producing better outcomes? At 16% of Gross Domestic Product (and climbing), the American healthcare system is 60-100% more expensive than any other industrialized country and yet we do not live as long as citizens there. Where all these countries cover 100% of their citizens, the American system leaves about 15% of its population (about 47 million people) uncovered at any one time (and even more if you include loss of coverage for extended periods, but not a whole year). Fifty percent of bankruptcies in the U.S. are due to medical bills. Americans avoid switching jobs for fear of losing coverage for pre-existing conditions. The U.S. manages to achieve these colossal failures while still expending 62% of all costs through the government (if civilian government employee's coverage is included as part of the government supported costs).
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Format: Hardcover Verified Purchase
Shannon Brownlee's manifesto, Overtreated, is a an extraordinarily important volume for those of us who question the mercantile thrust of health care in these United States. The sad reality is that to many physicians, hospitals, insurance carriers, and, of course, most pharmaceutical companies the American patient is a valuable cash cow. This impeccably researched book will allow the reader to make informed health care decisions. It is lucidly written and difficult to put down. It should be required reading for all who find themselves on the consumer end or "health care." As a physician, I will keep copies in my office for patients to peruse and borrow. Thank you, Ms. Brownlee for shedding light on a dimly lit landscape.
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Format: Hardcover

"[This book] is an exploration of three simple questions:

(1) What drives unnecessary health care?
(2) Why should we worry about it?
(3) And once we understand how pervasive it is in American medicine, how can we use that knowledge to create a better system?"

The above is found in this stunning, eye-opening book authored by medicine, health care, and biotechnology and award-winning journalist Shannon Brownlee.

Note that even though this book concentrates on the American healthcare system, what it says can be applied to the Canadian and European systems as well.

People familiar with the problems in healthcare will be familiar with some of the contents of this book. What they won't be familiar with is the true-life patient and whistle-blower stories (many of them ending up tragically) that Brownlee discusses to drive home the points she makes.

Almost every page has something interesting on it. I will provide a sample sentence from each chapter of this gripping book (these are just the tip of the iceberg):

(1) "As research would show over the coming decades, stunningly little of what physicians do has ever been examined scientifically, and when many treatments and procedures have been put to the test, they have turned out to cause more harm than good."
(2) "Every patient admitted to a hospital risks being hurt or even killed by the very people who wish to help her."
(3) "After blowing the whistle on the hospital and its specialists, he would lose practically everything he valued, his medical practice, his family, and his home."
(4) "The supply of medical resources, rather than the underlying needs of patients, is determining how much medical care they get.
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Format: Hardcover
This is an extremely important book to read for anyone who has or will come into contact with the healthcare industry - that is pretty much every single person alive in the USA. The current health care system is broken very badly. The media and politicians talk about it but not enough. The problem is far more serious than any national issue. The US spends over 15% of its GDP per capita on health care which is by far the greatest amount compared to other nations. What do we get for it? According to WHO the our outcomes are roughly comparable to Chile (worse than Greece). For outcomes, I am using "Life expectancy at birth", "Healthy life expectancy at birth", and "Probability of dying between 15 and 60 years". (See [...] Chile spends only about 6% of their GDP on healthcare. There are lots of reasons for this poor performance but Brownlee discusses one that is rarely talked about which happens to be the most important reason. That reason is overtreating.

Brownlee has done her research very well and presents a well balanced (until the last chapter but more on that later) account of why our current system leads to overtreating. She discusses the three main reasons as being 1) fear of malpractice law suits by physicians (ie: doctor orders head CT scan for a patient with a headache even though chances of brain tumor is very small). The second reason is consumer demand (ie: patients demanding unnecessary tests) and finally financial incentives and culture in medicine (From early on medical students are taught to gain as much information as possible hence leading to unnecessary tests and procedures). All 3 reasons are valid. Perhaps Brownlee underestimates the importance of the first two reasons.
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