Media Type: Textbook

Synopsis: America’s health care is at a precipice, costing more than any other but producing considerably worse results than many others. Lasker Prize winner and former dean of the Johns Hopkins Bloomberg School of Public Health, Alfred Sommer brings his vast global experience and applies his academic rigor and wit to look at the contradictions inherent in the US health system, especially the disproportionate emphasis on expensive biomedical treatment of diseases over policy choices to invest in better social and economic environments that foster prevention and health promotion. Getting What We Deserve is immensely timely, engaging and thought provoking – a must read.

Target Audience: American health care policy makers, providers, consumers and voters

Review: Alfred Sommer is a Lasker-winning public health ophthalmologist and former dean of the Johns Hopkins Bloomberg School of Public Health. He has worked extensively to improve health care in the poorest countries, as well as serving on distinguished panels such as the National Academy of Sciences and the Institute of Medicine in the US and the World Economic Forum’s Global Governance Initiative. He is widely known for undertaking top caliber science, translating it to advocacy messages that resonate and persuasively shepherding issues through complex political processes – typically with wisecracks worthy of a native-born New Yorker.

His recent book Getting What We Deserve: Health and Medical Care in America is imminently timely as America engages in the most significant review of health care in decades. It should be of interest for anyone touched by America’s health care system – policy makers, providers and patients. In a short and highly readable work that is richly illustrated with approachable statistics and anecdotes, Sommer poses the question, “Why do Americans get such bad value for the money they spend on health?” Comparisons such as the life expectancies of a black man in Harlem to that of a Bangladeshi (better to be in Dhaka than on Lennox Avenue) set the stage to then explore options and opportunities to do better.

A central argument is that the US – more than any other rich country – massively over-relies and overspends on biomedical treatments, and that this is fueled by vested commercial interests and misinformation at every level of health decision-making, from the personal to the political. Sommer presents the facts that should point to a policy shift to better favor prevention and health promotion, particularly the social, environmental and economic factors than shape health behaviors. He argues for health care reform to ensure universal health care coverage for a ‘basic’ package of services predicated on a firm evidence base that guides use of medicines that can clearly demonstrate their value.

Sommer is addressing what is arguably the make-or-break question of the US economy for the decades to come. In many ways, this is a thinking person’s version of Michael Moore’s documentary Sicko . It also serves as an excellent trans-Atlantic companion to a recent release from the former head of the United Kingdom’s National Health Service, Lord Nigel Crisp, entitled Turning the World Upside Down – The Search for Global Health in the 21st Century , which readers would do well to seek out in addition to the Sommer book. And Getting What We Deserve should remind us what an ophthalmologist can do when he opens his eyes.