More than Medicine: The Broken Promise of American Health

by Robert M. Kaplan

American science produces the best--and most expensive--medical treatments in the world. Yet U.S. citizens lag behind their global peers in life expectancy and quality of life. Robert Kaplan brings together extensive data to make the case that health care priorities in the United States are sorely misplaced. America's medical system is invested in attacking disease, but not in solving the social and behavioral problems that engender disease in the first place. Medicine is important, but many Americans act as though it were all important.

The U.S. stakes much of its health funding on the promise of high-tech diagnostics and miracle treatments, while ignoring strong evidence that the most significant pathways to health are nonmedical. Americans spend millions on drugs to treat high cholesterol, for example, which increase life expectancy by six to eight months on average. But they underfund education, which might extend life expectancy by as much as twelve years. Wars on infectious disease have paid off, but clinical trials for chronic conditions--costing billions--rarely confirm that new treatments extend life. By comparison, the National Institutes of Health spend just 3 percent of their budget on research in social and behavioral determinants of health, even though these factors account for 50 percent of premature deaths.

America's failure to take prevention seriously costs lives. More than Medicine argues that we need a shake-up in how we invest resources, and it offers a bold new vision for longer, healthier living.

Genres: Nonfiction, Health Care, Health

240 pages, Hardcover

Published February 4, 2019

About the author

Librarian Note: There is more than one author by this name in the Goodreads data base.

Dr. Robert M. Kaplan is a psychiatrist and clinical associate professor affiliated with the Graduate School of Medicine, University of Wollongong, Australia.

Reviews

[Bonnie Ayres · Rating 4 out of 5]

Gives clear insight as to why, despite millions of dollars spent on biomedical research and grants, this country is sicker than many other countries. Shows that the practice of medicine in America is focused more on trying to cure disease rather than prevent the it. Very much worth the read.

[Andrea]

Easy to read- made some good points.

Also made some false equivalencies-- correlation does not equal causation. Yes- level of education is a predictor of lifespan, but that is a stand-in for so many other variables. If you make everyone finish high school, that's not going to lengthen their life, because it doesn't fix all the other issues associated (like living conditions, clean water, food deserts, socio-economic stress, racial injustice, etc.)

I am totally on board with less funding for research supporting pharma companies, and redirecting those funds to improve the social determinants of health.

[Mark · Rating 3 out of 5]

Kaplan persuasively argues that the US is not spending its health care dollars wisely. Rather than allocating nearly all our resources to curing disease, which is expensive, he argues we should be pursuing wellness, a broader approach encompassing behavioral and societal metrics. He has the career credentials and the facts to lend a unique credibility to his ruminations on health and health care.

[Michael Dowling · Rating 4 out of 5]

Focuses on our need to re-prioritize and deal with the social, behavioral and environmental issues that affect your healthy--not just treatment of disease. Informative and timely.

[Chloe Cline · Rating 4 out of 5]

An extremely insightful perspective of the U.S. medical system - focusing primarily on spending, insufficiency, and overlooking social determinants of patient health. Highly recommend!

[Becca · Rating 2 out of 5]

No.

[Lance · Rating 5 out of 5]

More should be spent on the behavioral aspect of healthcare. What’s spent in this country on that aspect of healthcare is so much less than other countries. We have a lot to learn. Easy to read and the advise makes sense. Another point is that most studies of healthcare interventions look at surrogates since those are easier since they don’t take as long to get an answer. Instead, the question to be asked is whether actual length of life is any greater. In most instances, length of life is no different. For example, mammograms are recommended for screening, though if instead all-cause mortality is measured, there’s no difference in outcome whether or not regular mammograms are recommended.

[Anthony · Rating 4 out of 5]

Another case of how America continues to fall short in the health care field as compared to the rest of its global peers, although it produces the best and most expensive medical treatments. This debate focuses on the overspending and how it contributes to poor health. The viewpoint of scientific and clinical evidence reveals the amount spent on health care is not worth the costs as more people are not living any longer, or healthier in this disease attacking mentality society, as the social, behavioral, and environmental problems are overlooked when it comes to longevity and quality of life.

[Ozgun · Rating 4 out of 5]

A broken system that needs to be fixed not just about healthcare but about the social aspects