Code Blue: Inside America's Medical Industrial Complex

by Mike Magee

"Code Blue" is the phrase customarily announced over hospital public address systems to alert staff to an urgent medical emergency requiring immediate attention. How has the United States, with more resources than any nation, developed a healthcare system that delivers much poorer results, at near double the cost of any other developed country--such that legendary seer Warren Buffett calls the Medical Industrial Complex "the tapeworm of American economic competitiveness"? Mike Magee, M.D., who worked for years inside the Medical Industrial Complex administering a hospital and then as a senior executive at the giant pharmaceutical company Pfizer, has spent the last decade deconstructing the complex, often shocking rise of, and connectivity between, the pillars of our health system--Big Pharma, insurance companies, hospitals, the American Medical Association, and anyone affiliated with them. With an eye first and foremost on the bottom line rather than on the nation's health, each sector has for decades embraced cure over care, aiming to conquer disease rather than concentrate on the cultural and social factors that determine health. This decision Magee calls the "original sin" of our health system.

Code Blue is a riveting, character-driven narrative that draws back the curtain on the giant industry that consumes one out of every five American dollars. Making clear for the first time the mechanisms, greed, and collusion by which our medical system was built over the last eight decades--and arguing persuasively and urgently for the necessity of a single-payer, multi-plan insurance arena of the kind enjoyed by every other major developed nation--Mike Magee gives us invaluable perspective and inspiration by which we can, indeed, reshape the future.

Genres: Nonfiction, Science, Health, Medicine, Politics, Economics, Health Care

368 pages, Hardcover

First published May 1, 2019

About the author

Michael Magee was a British journalist. He is credited with introducing a tabloid-style approach to the coverage of technology news. In 2009 the Daily Telegraph placed Magee 35 in its list of Top 50 most influential Britons in technology.

Reviews

[Ell · Rating 5 out of 5]

Everything you should know about the Medical Industrial Complex in the United States in one riveting book! As a physician, former hospital administrator and former pharmaceutical executive, author Mike Magee takes us into the corporate world of one of the most complicated and costly industries in the US. This book dives into the history, context, back story, key players, legislation, competition and collusion that have shaped the nation’s present-day health care industry. Although there is quite a lot of content, this is anything but a dry read. It is insightful and thought-provoking.

[Dan Connors · Rating 4 out of 5]

As one who has luckily avoided the medical industrial complex for the most part, I still wonder how we got where we are with American health care, and why it's considered one of the worst systems in the world while also being the most expensive.

Dr. Magee is an expert in his field, and he showcases his experience at Pfizer during the Viagra gold rush. If you've been paying attention the past 20 years, you will recognize the names and changes that have made our system both dysfunctional and excellent, depending on luck and circumstances.

The medical industrial complex, as Dr. Magee calls it, consists of medical professionals, insurance companies, hospitals, big pharma, government and universities, all of whom collude with each other to protect their turf and maximize profitability.

The book dives into some of the history of how we got here, and how groups like the American Medical Association, Food and Drug Administration, Medicare, and the employer based health insurance system got their starts. One thing I didn't know was that after World War II, when the American government was helping rebuild Germany and Japan, they helped both countries establish public health insurance, while at the same time squashing it here at home as "socialized medicine." Presidents as diverse as Harry Truman, Richard Nixon, Bill Clinton and Barack Obama all tried to establish some sort of government health insurance like has emerged in all other industrialized countries, only to be beaten back by the medical industrial complex every time.

What's always puzzled me is how what we now know as Obamacare was actually dreamed up by the Republican party decades earlier. Now that same party is trying to destroy the Affordable Care Act with no clear alternatives being discussed.
More points brought up in the book:

- Advocacy groups like the American Cancer Society are funded by industry and more geared to heroic cures than to prevention.
- The people who monitor and evaluate hospitals are not independent. Hospitals can be very secretive about their prices and their accidental death rate (which has been going up according to the book.)
- Drugs for ADHD (ritalin and adderal) and Pain (opiods) are recommended by doctors and commercials way too much for minor conditions, with the result that the profit motive trumps sound healthcare. The author warns that all drug advertising and free samples to doctors should be stopped.
- Universities and researchers are beholden to the MIC, and have been known to stretch ethical boundaries with tests on human subjects and fudging their data to get the right result.
- Enormous amounts of health care dollars are spent on bureaucracy. For every physician there are 16 workers in the system, half of which add no clinical value at all.
- In order to pass health care reform, Obama had to agree not to negotiate drug prices or allow imports, leading to the scenario today where drugs in the US are often 10 times as expensive as the same drug in other countries.

The final chapter of the book lists reforms that the author thinks would help the health care system catch up to the rest of the world (where he claims we are number 50 of 55 comparable countries in overall health.) The big reform, which has been discussed by many, would be some kind of single payer, government based healthcare that would eliminate the middlemen and rein in the profiteers.
After watching this debate for most of my life, I'm not too hopeful because the current system is so entrenched, but I highly recommend this book to those in the healthcare field and those who use the system regularly.

[Nina · Rating 5 out of 5]

This book explains the history of the medical agencies, organizations and associations, governmental, for-profit and nonprofit that have exerted influence to create the healthcare system we have today. The roles of the three most powerful sources of influence, hospitals, insurance companies and pharmaceutical companies are described at length. The author, as a medical doctor who has worked for Pfizer and universities and hospitals, has the experience and inside information that gives this account a wealth of credibility. He offers a variety of solutions at the end. This book is such an eye opener you will never look at healthcare the same way again. It should be required reading for all medical students.

[Morgan · Rating 3 out of 5]

As an exposé, Code Blue is at times interesting but also somewhat disorganized and repetitive. My big gripe is that discussion of solutions to our medical system's problems is smashed into a tiny chapter at the end, where Magee spews out tons of massive changes that he is in support of but doesn't give thoughtful explanation about the viability or the pros and cons of any of them. If you want to learn about this topic, there are better books out there.

[Becky Loader · Rating 3 out of 5]

Magee pulls no punches in his well-documented book on the health industry. It is depressing, though.

[Emily Ack · Rating 2 out of 5]

DNF @ 67%

I picked this book up because the American health care system is messed up and I don't see enough people discussing it. There are a lot of intricacies to learn... virtually endless, because there I suspect there is a lot of corruption that is being buried.

Mike Magee appears to be in a great position for this analysis. However, he missed the mark in this. For one, WHO is his audience? The work is too dense for an average reader. Each chapter should have had a summary of key points. Ultimately, too, I can't walk away from this book being able to formulate arguments, an analysis, or strategies of change. So what's the point? Who is this for?

Magee heavily looks toward universal health care as the solution. The ONLY solution, actually. Which I'm not sympathetic to, because I don't think that solves the MIC. It doesn't solve the pharmaceuticals, the lavish grants, and protective laws. It seems that many people look to universal health care as the ultimate route, except my issue is: no one has ever been able to wholeheartedly argue FOR it compared to OTHER suggestions. Are there even other suggestions? Those voices are drowned out. People treat this as a binary issue, when I think reform could take endless routes... but those voices aren't considered. All of this is to say that Mike Magee didn't convince me on any solid grounds. The argument merely is, "It's better than what we currently have." Which is a given.

Magee also doesn't convey any understanding or knowledge of confounding variables, or even the truth of statistics. When he laments the 'high maternal mortality rate of the US,' it's something like 43 / 100,000 births, compared to other nations at 19 / 100,000. In other words, both less than 0.5% of births. On top of that, there is no consideration for confounding variables. Could it be that the US has higher co-morbidities (including weight and diabetes) than other nations? Could it be that other countries are more likely to abort if there's a suspicion of complications? Or another factor could be comparing IVF rates, which increase your high-risk pregnancies. I use this as one example, but if there are questions about this one angle, how many more of the stats he drops could be contested?

Magee's chapters do case studies as if the one story embodies the entire picture. For instance, his chapter on pharmaceutical marketing highlighted Sackler, and the chapter on advocacy followed Mary Lasker and Florence Mahoney. Although these individuals had a large reach and a lasting impact, the current corruption surely has more examples. It's these case studies and their detail that got tedious.

He really lost me when he started getting overtly biased in his sweeping statements.

We need more exposure on these topics. But this book is not accessible to the average reader, which means it's not good for educating the public at large. It was a missed opportunity to exclude chapter highlights and summaries. Likely this was excluded because some of the chapters would have a summary that conveys his political biases more than anything insightful. I would be surprised if people could walk away with coherent arguments from this.

Your basic summaries are fine, but not exactly new:
"The healthcare system was allowed to be big business rather than a citizen right. Pharmaceutical companies launch millions of dollars into lobbying government for their own benefits. Even organizations, the AMA as a big one, cared more about business aspects than promoting honor among the profession. Research got tangled up with this, and we spend far more on research than we do on any preventive care. Research tends to be too far-reaching (i.e. 'cure cancer') rather than exploratory, which could potentially yield better results. Public health, which is part of preventive medicine, is lacking funding. Universal Health Care would reduce overall costs, including cost reduction through reducing overhead and claims processing."

[Bob H · Rating 5 out of 5]

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.

(Reviewed in advance reading copy by Amazon Vine.)

[Julie Stielstra · Rating 4 out of 5]

Pretty much everyone agrees the American healthcare system (if you can even call it that) is broken. Badly broken. Mike Magee is here to tell you how it got that way, and it's worse than you imagined. Decade upon decade of collusion (yes! collusion!), connivance, coverups, downright criminal behavior, politicking, horse-trading, lies and more lies are the core ingredients of what Magee calls the Medical-Industrial Complex, the cabal of insurers, pharma executives, trade associations, academic and research institutions who have all joined hands (and sometimes fought, changed sides, made up, then fell out again) in pursuit of... public health? better medical care? high-tech disease-curing breakthroughs? care for the poor, the elderly, the sick? Uh-uh. Money. It's ALL about the money.

He knows whereof he speaks, having been a very successful part of it for much of his career as a physician, educator, hospital administrator, and finally a high-level honcho at Pfizer Pharmaceuticals. This is where I can't shake off some queasiness about why, if it was so bad and he knew it, how come it took him so long to get out? Nevertheless, this is a detailed, damning, closely referenced account of the nightmare.

It is enlightening to read the blazing criticism of Medicare when it was proposed in the early 60's... because it uses the same language and tactics we heard about the Affordable Care Act under Obama, and that we hear daily today about any alternative system being proposed. And guess what? Medicare worked out quite nicely, thank you. The chapter on the opioid crisis doesn't describe much more than we already know... except for the back room, shell-company, sweetheart dealings expertly managed by the likes of the Sacklers.

Vivid, appalling, and very very important. Read it.

[Brian · Rating 5 out of 5]

Code Blue by Dr. Mike Magee takes a look at the idea of a Medical Industrial Complex akin to the Military Industrial Complex that President Eisenhower warned of. This complex is made up of Hosptials, insurers, pharmacists, professional medical organizations, and government entities including but not limited to the FDA, NIH and members of congress. This group has shaped and destroyed American health care by putting profits ahead of practice, disease research ahead of managed health and a pursuit that has led to sub optimal outcomes in health care. While it is clear that Mike Magee believes a single payer is the only way out he lays out his reasoning carefully and soundly. While I would like to believe there is a more free market way out that puts the labor market back on the onus of providing employer based health insurance as we proliferate right to work states that seems to be less and less likely. The author hear knows his topic well having been a physician, worked for Pfizer and then as a policy analyst writing on the topic of health care in America.
This book is well researched and for those who want an informed opinion of how we got to where we are this is a very good place to start. With my own background in health and pharma economics I found this a fascinating read and largely jived wit he macro data I have studied on health care trends. In short for 300 pages the author covers a tremendous amount of ground accurately and succinctly with thoughtful analysis that bears closer study.

[Jillian Marena · Rating 3 out of 5]

Really difficult to read. I felt as though the authors thoughts were always jumping from one subject to another.

[Jeanne · Rating 4 out of 5]

This should be required reading.... not a fun read, but ever so important. It gives the historical context for the major issues in our healthcare system, and probably society in general. The collusion of the medical industrial complex, focus on cure over care, and plain greediness are themes throughout this book. Hopefully single payer and checks on the medical industrial complex can become reality, along with meaningful and safe development and cost containment as our population ages.

[Nancy · Rating 4 out of 5]

West Hartford Public Library is offering an online event with Dr. Magee to discuss Code Blue. I registered for the event and was also able to borrow the audiobook from my awesome library.

Code Blue is a deep look into the medical industry in America. The history of our health care and comparisons to other nations are presented. There's also an uncovering of practices in hospitals, insurance companies, big pharma, lobbyists and politics. It was more than a confirmation of my own skepticism.

I look forward to the presentation later this week.

[J.S. Nelson · Rating 3 out of 5]

Thank you for blowing the whistle on the widespread corruption & the overwhelming reality of practices that are only worsening people's health! The author's "basic steps to fix the medical industrial complex" are great suggestions that anyone (except the elite pharmaceutical aristocracy) can get behind.

What I didn't like:
the author states his political views (VERY repetitively) & pushes for political reform to force people to pick from only a certain, limited selection of providers, & allowing the government to forcibly take WAY more money from hard-working people that are barely scraping by as it is, in order to pay the exorbitant prices that are one of the root causes of the MIC (as he terms it) issue to begin with.

His push for reforms to take even MORE money in taxes from those of us that already struggle to pay the bills in order to pay Big Pharma's demands (instead of addressing the ACTUAL issue... like the cost of making a drug for $2 a pop then pricing it for $350+ a pop, while enacting their legal shenanigans & lobbying army to make this the only legal way to treat disease)
in exchange for a plan where we the strugglers STILL have to pay from what little earnings the government allows us to keep, for eyeglasses/contacts and dental health... let's just say this author really needs to stick to his specialty (medical industry) and stay the heck out of politics.

[Ed Bernard · Rating 5 out of 5]

A comprehensive indictment of the American system of health care by someone who should know — McGee has been a working physician AND an executive of a large pharma company (Pfizer) so he knows a couple of sides of this convoluted, deeply screwed up narrative personally. He skewers what he calls the Medical Industrial Complex thoroughly — its history, the self-serving and shameful conduct of the AMA, the unholy alliance between researchers and drug companies, all of it. Here are two random facts that should outrage everyone: 1) as part of the Marshall Plan, the US outfitted our two most significant foes in WWII (Germany and Japan) with a shiny new healthcare system that operated from the assumption that a healthy citizenry was essential for a functional first-world nation, and thus made a system that was both affordable and effective. When Truman tried to implement the SAME system in the US, resistance from the AMA (the first to label a government operated single payer system “socialized medicine,” a legacy that still haunts today) scuttled the plan. Which leads to fact 2) the US has by far the highest health care costs in the world … and our outcomes are the worst — by one count, 15th out of 15 nations. Since the 40’s, the drug companies have become rich and powerful as well, so we now have absurdities like American drug companies exporting drugs to Canada, where Canadians pay far lower prices because the costs are negotiated by the government, not for-profit insurers … AND, American providers can’t re-import these drugs on the ridiculous premise that the FDA can’t ensure that they are safe and effective. Our own drugs! It’s just nuts. Who knew health care was so complicated (to toss a gratuitous jibe at Donald Trump … sorry, it was just sitting there teed up, gotta take a swing at it)? McGee offers a few ideas to get us out of this mess which seem fraught with either existential problems or unlikely to solve much, but it hardly even matters — the core of this book is his scathing indictment of the MIC and he handles it with clarity, equanimity and engaging narratives. Just a brilliant book that everyone should read.

Grade: A

[Anne · Rating 5 out of 5]

Is the problem with health care in America caused by its being a profit driven business?
Is healthy business in direct competition with providing health care for all citizens?
“The AMA serves the financial interests of its members, not primarily the health and well-being of the American people.” Does this compromise the quality and cost of health care in our country? These issues and more are covered by a former industry insider and medical doctor. This is an interesting study of the Medical Industrial Complex and what many believe is a serious problem in our country today.

“The American system of [pharmaceutical] research is rife with unethical conduct and financial conflict of interest...studies have been conducted in underdeveloped countries on “children who were often gravely ill, undernourished and highly vulnerable...and where medical personnel have been really badly taxed.” These are major pharmaceutical companies with recognizable names and an industry driven by a profit motive.

“As Americans bear the brunt of high cost and low performance, every other developed nation far exceeds our rate of progress in dealing with such basics as infant mortality, immunizations, infectious disease rate, malnutrition, and sanitation.”

This book is for anyone who wants to take a peek behind the curtain of the medical establishment. The author is a knowledgeable industry expert and uses verifiable statistics and studies all well documented in endnotes. He closes the book with a multi-point plan to reform the existing medical coverage in this country.

[Deb · Rating 3 out of 5]

I was hoping for a view from some inside the MIC and instead I got a detailed history of how we ended up with the medical system that we have. This book could have be written by anyone willing to do the research as everything that is detailed in this book exists in either the historical record or recent media. Much of it will be familiar to anyone who has followed the news over the past few decades.

The thing that disappoints the most is how absent the author is from this work. If he signed non-discloses that limited his ability to share anything not already documented elsewhere (which seems likely) then he should have explained that at the onset. A single sentence in the afterward is the only mention he makes of his own personal choices to assist the great machine. I would have loved to hear how he weighed his choices and decided to be a paid spokesperson for Pfizer, a company with a hideous record of deception that has led to countless deaths. In all his years, did he have no doubts? It seems very convenient that he waited until after retirement to suddenly grow a conscience. It might have mattered more had he attempted to sound the alarm when he actually had some skin in the game. Instead this reads like someone with a guilty conscience trying to make amends that are long past overdue.

[HollyLovesBooks · Rating 5 out of 5]

This is such an important book looking at an insider's view (from multiple perspectives) of the medical industrial complex. Some may complain or moan that Dr. Magee is selling the medical community or administrators out by telling this story but it needs to be publicly told. In this day and age, when our country, as wealthy as it is, has such awful statistics in the healthcare sector for easily preventable conditions, we need to know these facts. Washington, D.C. politics are too busy vying for power and not representing the needs of Americans when it comes to many issues, but healthcare is one that will universally affect each and every one of us.
Wake up people! Everyone dies! Therefore, preventing disease is important. Treating disease early is important. Having easy access to high quality care is important. Instead we are allowing decisions to be made by the MIC that will ultimately affect our ability to access these services (and for providers to provide them).
Thank you Dr. Mike Magee for this timely and comprehensive book outlining the background and conversation we need to be having in this country now about how we want our healthcare to be for the coming years and why it became the way that it is now.

Highly recommend!!
#CodeBlue #NetGalley

[Corey Nelson · Rating 5 out of 5]

Got this book before Covid-19 hit but reading during a world pandemic made it even easier to appreciate the author’s points about how the medical industry complex “MIC”. Four key aspects of the system: hospitals, pharmaceutical companies, insurance companies, and government are not helping as they should be (or we think).

The history of each of the MIC components is educational. I appreciated how the book was laid out to show how each is independent in their focus yet deeply intwined in what we have to date.

Dr Magee has a varied and extremely relevant experience from which I learned a lot and are rethinking a few things.

[Pamela Wilbur · Rating 5 out of 5]

Burn it all down.
The book exposes how doctors, drug companies, hospitals, pharmacies, insurers, lawmakers and special interests have colluded over the years to protect their own turf and profits, despite relentless public demand for a system that serves patients instead of entrepreneurs. It's no wonder they've lost respect & credibility. Why are people so corrupt?

[Dorie - Cats&Books :) · Rating 3 out of 5]

Review to follow

[Fred · Rating 3 out of 5]

There are some political books that invoke ire at injustices solely from the content of the book or the information being portrayed while simultaneously giving the air of neutrality or objectiveness (e.g. Dark Money by Jane Meyer). Then there are books like Code Blue, where the content is upsetting and revealing, but the author is upset too and it comes off as vindictive, likely because Mike Magee actually worked for Pfizer for 10 years.

I wanted a book that dove into how American healthcare works, who all the players are, why it's so expensive yet Americans are so unhealthy. Mike Magee does a fairly decent job of that, showing how the American Medical Association, pharmaceutical giants, insurance companies, doctors, lobbyists, and elected representatives work together to pass laws and earn profits at the expense of taxpayers and the health of everyday citizens. It's essentially a vertically integrated system.

Where he falters is in his close ties to Pfizer. He uses Pfizer in nearly every chapter as an example of how enmeshed corporations are in our healthcare, which I feel narrows the scope of the book. They are incredibly integrated but there are multiple other large players in the game (e.g. insurance companies) that don't get nearly as much screen time (for lack of a better word). There's even a 3-4 page list at the end of the book of all of Pfizer's payouts for their transgressions and lawsuits. It's almost like he wanted to write two books: one about how our healthcare works and one about how Pfizer sucks, but fell into an awkward middle.

Aside from that, him being a physician, he looooves details. I'll tell ya, I could not care less for the chemical name of popular pharmaceuticals or how person X knew person Y who spoke to person Z from 1990-1992 on the third floor of some Hilton in Manhattan.

All in all, I learned some about how our healthcare works and learned more than I cared to about Pfizer. Looking forward to reading some other healthcare books that aren't as close to home to the author, like An American Sickness, The Healing of America, and Which Country Has the World's Best Health Care?.

[Barbara Clarke · Rating 4 out of 5]

Because I'm working on a memoir/nonfiction book about my own working experience and later research on the busted US healthcare system, I took notes on this book and a second read. We call it a system (not really a system at all - more like a roulette wheel of chance - more like the rich get the care they want whether it's good for them or not, and the rest of us, go broke, get too much or not enough care from doctors who are either fried, avaricious, ploys of the RX industry, or owned by those who happily put profits over patients - hospital chains, insurance companies, pharmacy benefit managers, the medical device companies, and...congress who does nothing but accept campaign cash and lets lobbyists and large corporations and oligarchs (with a major financial interest in legislation) write the legislation. Corruption at its finest!!!

Like Dr. Marty Markary's book, The Price We Pay, Magee has been on the inside - of probably the worst of the worst - Pfizer. He not only received large grants from them but also worked for them. Not until he and the wife saw The Constant Gardener and wife pointed out - "that's Pfizer" - did the good doc wake up. This is the same as Wendell Potter who was the PR VIP for Cigna - also woke up so very late, possibly as his retirement was all set. What took these guys so long? Money, ambition, prestige, ego, money, and money. While I'm glad they saw the light and wrote about what they saw, what I saw in my first year working as a sales rep, it took them decades to figure out.

To his credit Magee does give a list of To Do's at the end and I can't disagree with any of his suggestions. But... and it's a big but...these docs aren't leading the charge to finally get universal coverage on the table, in the public, with advocates, gosh - even demonstrations, strikes, community organizing. Why not? Too hands on that might cost you a few friends? Maybe even get you censored by your industry? Or, turn you and others into a hero?

The clock is ticking - for all of the talk about the next pandemic, nothing is being done about the healthcare system that will officially collapse the next time around.

[S Walker · Rating 2 out of 5]

This book is the definition of narrow-minded. The author sees what he wants to see--and only that. He has in mind a general framework for the country's health care structure and he just continually pounds on that nail. For example, he says "Americans realize that a segment of our population cannot afford insurance, and that costs for their care must be subsidized by the rest of us." and yet in his narrow-minded praise for all things Obamacare he doesn't recognize that THE REST OF US is not what is subsidizing those unable to afford insurance instead there is only a select group of individuals paying and this group does not include employees whose health care is paid by their employers' health insurance plans, federal employees, retired government employees with generous taxpayer funded health insurance, etc. There actually were alternative approaches offered to provide subsidies. One can agree on the end but not necessarily the means to the end. Other topics he fails to introduce: why there is so much overspending on the end-of-life care? what role does medical malpractice play in inflating our national health expenditure bill? What happened to the effort started by Buffet, Dimon and Bezos to overhaul health care? Why not introduce a individual tax on employer provided health benefits?
The only chapter worth reading was the one on Viagra, perhaps because he actually knew something about the events here and he wasn't just swallowing the left wing legacy media without having chewed or tasted.

[Bob Jenkins · Rating 5 out of 5]

I wanted a change of pace a bit with this book. The medical industrial complex of our country.
The author is a MD who has had a variety of positions but he writes this book mostly from the position of a former Pfizer employee from the C Suite, working with the introduction of Viagra.
First he walks through history of how we got here, and he speaks to the many conflicts within our medical system in the USA
The author is clearly building an argument on how awful our medical system is when compared to the world. He points out that we do not treat people for Wellness, it rather we want to find the next great vaccine or magic cure that our pharmaceutical companies can sell around the world. The rest of the world pushes wellness on all.
I do wonder that it is because of how we are, that the rest of the world let’s us invent everything and they focus on staying healthy.
A great read, learned a lot and the author is clearly pushing for a single payer system. He makes a very good argument for at least changing towards that direction.

[TheManInThePlanet · Rating 3 out of 5]

Without a doubt, this book is essential reading for those wanting a complete picture of America's healthcare system and how it came to be what it is today. Mike Magee's impressive work in this book is borrowed from voracious research and years of experience in the medical industrial complex in a variety of positions.

Somewhat hindering the impact is Magee's sometimes clinical and jargony use of language. The book isn't always as accessible as it could be, and close reading is required for those who want a clear grasp on the intricacies of this system. Of course, the complexity is part of the point. Corrupt systems often get by due to their inscrutability. Just think of how unnecessarily complicated our tax system is. Still, one would hope that an author writing a book on the issue would want to do better at explaining these things to laypersons, although perhaps that's asking too much.

[Ari Damoulakis · Rating 4 out of 5]

So this was a really interesting book. It is incredible the profits the pharmaceutical industry makes. I am still a bit unsure why the poor in America can’t afford healthcare, I am not talking about medication, the book explains that, but even more basic problems.
I actually would like to find resources that deal with the behaviour of the pharmaceutical industry and prices in SA, but, I must be honest, even poor people here, I have not heard stories of them dying from having to ration insulin.
Yeah the public hospitals are mostly awful, but at least the government is trying.
It is ridiculous how the richest country in the world does so little for its poorest people and their health when they could really be helped and catered for properly.

[Andrew Degruccio · Rating 5 out of 5]

Giving this 5 stars because it is a must read for anyone who thinks they understand the complexity of the medical industrial complex. I think Dr. Magee covered a lot of ground in just over 300 pages. Sure some glossing over topics and jumping from topics occurs, but that was simply in an obvious attempt at brevity while preserving a complete coverage of the disaster that is American medicine. He gives great guidance on fixing the system. The importance of many of his recommendations may be lost on those not caught up in the medical industrial complex, but I found them all to be well thought out. Well done.

[Randi · Rating 5 out of 5]

I had to take breaks from this audiobook at times because it was just so disheartening to see how selfishly, even sociopathically, people have acted throughout history and in recent history as well... But at the same time, I'm glad I stuck it out. It was very illuminating, and even when I disagreed with the author (such as on abortion and the motivations behind Catholic teachings) I respected his views. Everyone needs to know this ugly history and the ugly truth of the present. It's not all ugly, though: the final chapter presents a hopeful vision of what we could still do to make things better!

[Esha C · Rating 4 out of 5]

Code Blue is incredibly well researched. I learned so much about the complexities of the USA healthcare system from every possible angle. I was especially surprised to learn about the role of doctors, and patient advocacy groups in the intricate web of the health establishment. As an aspiring physician, it has definitely inspired me to work towards make our system more streamlined in the future.

The only thing I wished was that the book provided more potential solutions throughout the read instead of only highlighting issues. Overall a very informative and important read for anyone entering the health professions.

[Robert Patterson · Rating 4 out of 5]

Riveting. Gives an entire overview, historical, contextual, over what Dr Magee who as a former Dr, hospital administrator, Pfizer executive and heath sector veteran dubs the Medical Industrial Complex. Convincing, thorough and engaging in a complex topic.
The insider take on the profits of all sectors over health benefits showcases why the US lags behind developing countries in health outcomes while costing 2x 3x more than other developed countries.

Frustrating.