One-Minute Book Reviews

September 28, 2009

Excuses Used by Aetna, Prudential and Blue Shield to Deny Health-Insurance Claims — From T. R. Reid’s ‘The Healing of America’

I was going to read The Lost Symbol over the weekend but picked up T. R. Reid’s elegant indictment of health care in the U.S., The Healing of America (Penguin, 277 pp., $25.95). And I was hooked after the first sentence: “If Nikki White had been a resident of any other rich country, she would be alive today.”

Reid had his bad shoulder examined by doctors in other well-off democracies that included France, Germany, Great Britain, Japan and Canada. And he uses the results as a springboard for exposing flaws in arguments made by insurers and others against adopting practices that work overseas: “It’s all socialized medicine over there,” “They ration care with waiting lists and limited choice,” “Those systems are too foreign to work in the United States,” and more.

Until I can review The Healing of America, here’s a brief excerpt from the book about the excuses used by major insurers to reject claims:

“In other developed countries, insurers are required to pay every claim. But U.S. insurance companies deny about 30 percent of all claims, although some of these are eventually paid through an appeal process. The reasons cited for denying valid claims can be ingenious. When our family lived in Japan, the friendly adjusters at Prudential used to deny our claims for medical or dental care on the grounds that the bills we submitted were denominated in yen. Somebody at Prudential had determined that the Japanese yen was a foreign currency; that violated the rules. My company later switched our health insurance to Aetna, which employed a similar dodge: The adjuster said she couldn’t pay our claims because she couldn’t call the doctor’s office to verify the bills. It seems that Aetna had a phone system for its adjusters that didn’t allow international calls, so our claims had to be denied.

“The most maddening of all the profit-maximizing mechanisms in the U.S. health insurance industry is the practice known as ‘rescission,’ a legal term that means ‘We’re canceling your coverage.’ This occurs when an injured person who has been paying premiums for months or years has a serious accident or contracts a serious disease, which can mean serious bills for the insurance company to pay. At that point, the insurer’s Rescission Department digs through all the records, looking for a reason to cancel the sick person’s coverage. For example, Steven Hailey, a machinist in Cypress, California, paid his health insurance premium every month. Then he was hit by a truck. He was still being treated for his injuries when Blue Shield of California wrote to tell him that his coverage had been canceled because his weight was too high. He would have to pay the hospital bills himself – about $450,000 worth of bills.”

September 3, 2009

What If You Had an Autistic Disorder and Didn’t Know It? Tim Page’s Memoir of Growing Up With Undiagnosed Asperger’s Syndrome, ‘Parallel Play’

Filed under: Memoirs,News,Nonfiction — 1minutebookreviewswordpresscom @ 12:40 pm
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Tim Page is a friend, and I’m in the acknowledgments of his acclaimed biography of the novelist Dawn Powell, which – you will not be surprised to hear – I love. So I can’t review his new Parallel Play: Growing Up With Undiagnosed Asperger’s (Doubleday, 196 pp., $26). But Janet Maslin writes in today’s New York Times that this “improbably lovely memoir” shows in “fascinatingly precise detail and often to pricelessly funny effect” what it’s like to have his autistic disorder and not know it. And nothing in her review conflicts with what I know about Tim, who won the Pulitzer Prize for his music criticism for the Washington Post before he decamped to academia. The Times has also posted an excerpt from Parallel Play, a book that is an expanded version of material that appeared in The New Yorker.

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August 26, 2009

Before Ted Kennedy’s Brain Tumor, There Was Johnny Gunther’s

Filed under: Classics,Memoirs,News — 1minutebookreviewswordpresscom @ 11:40 am
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Malignant brain tumors such as that of Sen. Ted Kennedy (1932-2009) are uncommon enough that they have received less attention in books than many other types of cancer. One exception to the pattern is Death Be Not Proud, John Gunther’s eloquent memoir of the death of his 17-year-old son, Johnny, from a fatal glioma diagnosed when he was in high school. American views of cancer have undergone a sea-change since the book was first published in 1949. But this modern classic remains one of the finest accounts we have of the physical and emotional toll that a malignant brain tumor takes on patients, even those who might seem to have all the advantages. This post first appeared in 2008.

www.twitter.com/janiceharayda

May 1, 2009

CDC Projected Death Toll for Flu Pandemic: 89,000 to 207,000 People — Army Estimates That 1.7 Million Americans Could Die

Filed under: News — 1minutebookreviewswordpresscom @ 3:08 am
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In 1999 the Centers for Disease Control and Prevention issued a report on what might happen if a pandemic virus – similar to the relatively mild virus of 1968 – struck the United States. It estimated that between 89,000 and 207,000 people in the U.S. would die. Why so many?

John Barry responds in The Great Influenza: The Epic Story of the Deadliest Plague in History (Penguin, 2005):

“The reason for this high toll is the same reason that the CDC has concluded that, despite medical advances,  more Americans are now dying from ordinary, endemic influenza than in the past: in 1918, 1957, and even 1968 relatively few people alive had impaired immune systems. Today a large and growing number of people do – primarily the elderly, but also cancer survivors who have undergone chemotherapy or radiation, transplant recipients, those infected with HIV, and others.”

The figures in the first paragraph appear in Barry’s fine book, and his endnotes give their source as “Modeling the Economic Impact of Pandemic Influenza in the United States: Implications for Setting Priorities for Intervention,” by Martin I. Meltzer, Nancy J. Cox, and Keiji Fukuda. (See Figure 2 under “Results – Deaths.”) Meltzer’s paper has other information about the possible scope of a pandemic, including the percentages of deaths expected in different age groups.

Barry also writes that “the World Health Organization estimates that a virus akin to that of 1968 would, in today’s world, kill between 2 million and 7.4 million people worldwide.” The Washington Post reported in 2006 that WHO estimated that a virus akin to that of 1918 would kill 62 million people worldwide.

The CDC’s projected figures are much lower than those in a United States Army War College Program Research Paper “The 1918 Flu Pandemic: Implications for Homeland Security in the New Millennium,” which you can find easily by pasting the phrase in quotations into the Google search bar (though I can’t seem to link to it). That paper puts the estimated death toll for a flu pandemic at 1.7 million Americans.

For more on flu-related books, please follow www.twitter.com/janiceharayda.

April 30, 2009

Could the Swine Flu Pandemic Have Two Waves? Quote of the Day From ‘Flu,’ Gina Kolata’s Account of the 1918 Pandemic

Filed under: Nonfiction,Quotes of the Day — 1minutebookreviewswordpresscom @ 11:22 pm
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Could the latest swine flu outbreak be the first of two waves of the disease? And could the second be deadlier than the one that has just struck? Few medical experts are discussing the possibility publicly. But you might wonder after reading Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It, by Gina Kolata, a science reporter for the New York Times. Kolata writes:

“No one knows for sure where the 1918 flu came from or how it turned into such a killer strain. All that is known is that it began as an ordinary flu but then it changed. It infected people in the spring of 1918, sickening its victims for about three days with chills and fever, but rarely killing them. Then it disappeared, returning in the fall with the power of a juggernaut.

“In retrospect, medical experts talk of the two waves of the 1918 flu. The first was banal, easily forgotten. No one mentioned plagues or germ warfare when the influenza epidemic first arrived. But when it came back, in the second wave, it had turned into something monstrous, bearing little resemblance to what is ordinarily thought of as the flu.”

November 5, 2008

Late Night With Jan Harayda – A Blog on Cancer That Begins Where Books Leave Off

Filed under: Blogging News — 1minutebookreviewswordpresscom @ 11:44 pm
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Even the best books on cancer often have a built-in liability. It typically takes at least a year to write a book and another nine months or so for the finished manuscript to appear in print. The result? Good books may not reflect the latest research, a liability for anyone trying to make complex decisions about treatment.

So tonight I’d like to go off message and recommend a new blog on cancer by two good reporters — one a caregiver and the other a patient – both on staff at the Record in northern New Jersey. Leslie Brody has been helping her husband cope with pancreatic cancer since his diagnosis in 2006. My friend Lindy Washburn is a health-care writer for the Record who had surgery and radiation for breast cancer in 2007. Washburn is a two-time winner of the New Jersey Press Association Journalist of the Year Award and a three-time Pulitzer Prize nominee, who has also won the Investigative Reporters and Editors gold medal and was part of a team that won first-ever Grantham Prize for environmental reporting.

Brody and Washburn wrote a moving and series of articles about their experiences www.northjersey.com/specialreports/livingwithcancer.html. And it led to their Living With Cancer blog www.njmg.typepad.com/cancerblog/, which combines personal stories with up-to-date reporting and links to other good sources of information on cancer.

There are good blogs on cancer and good blogs by newspaper reporters, but Living With Cancer is both. If cancer has touched your life, this site is worth visiting.

© 2008 Janice Harayda. All rights reserved.
www.janiceharayda.com

September 18, 2008

Maybe You Don’t Need That Colonoscopy or Those Statins — A Noted Doctor Challenges the Medical Establishment – ‘Let My Polyps Go’

Angioplasties and stents are "good ideas that proved bad."

“Dr. Hadler sees no evidence that mild high blood pressure or mildly elevated blood sugar pose much of a risk to longevity — certainly not enough to warrant the aggressive drug treatment often offered for them. The same goes for … the modest elevations in serum cholesterol that, these days, spell a statin drug for life for many healthy people.”

Self-help books that urge you to micromanage every health risk have become disease unto themselves. So it was cheering to see the New York Times giving serious attention to a new book by a noted physician who still believes that less medicine can be more.

Abigail Zuger, an internist and frequent contributor to Times, recently reviewed Worried Sick: A Prescription for Health in an Overtreated America (Univesity of North Carolina Press, 376 pp., $28), by Nortin M. Hadler, “a rheumatologist and professor of medicine at the University of North Carolina who is a longtime debunker of much the establishment holds dear.” Zuger wrote:

“Dr. Hadler may not actually keep a skull on his desk, but he might as well. We are all going to die, he reminds us. Holding every dire illness at bay forever is simply not an option. The real goal is to reach a venerable age — say 85 — more or less intact.”

Zuger adds that Hadler believes the way to achieve that goal is to ignore much of the conventional advice:

“Reviewing the data behind many of the widely endorsed medical truths of our day, he concludes that most come up too short on benefit and too high on risk to justify widespread credence.

“Dr. Hadler sees no evidence that mild high blood pressure or mildly elevated blood sugar pose much of a risk to longevity — certainly not enough to warrant the aggressive drug treatment often offered for them. The same goes for the extra 20 pounds that make you overweight but not obese, and the modest elevations in serum cholesterol that, these days, spell a statin drug for life for many healthy people.

“He deplores the careful attention we pay to the state of our coronary arteries. Angioplasties, stents, coronary artery bypass grafts — all these procedures, he writes, ‘should be consigned to the annals of good ideas that proved bad.’

“As for the screening that purportedly keeps us safe from cancer, mammography and the blood test for prostate cancer are, in his view, blunt cudgels that can harm as much as help. Nor does he want any part of routine colonoscopies: ‘Let my polyps go.’”

Zuger compared Worried Sick with a new guide by Nancy Snyderman, a surgeon and the chief medical editor of NBC News, who — as anyone who has watched her televised reports may know — is ever-ready to parrot the medical establishment’s prescriptive-flavor-of-the-week. And though Zuger doesn’t come down on the side of either approach, her review is lively, open-minded, and worth reading www.nytimes.com/2008/06/24/health/24book.html?ref=science.

To read more about Hadler and Worried Sick, click here uncpress.unc.edu/browse/book_detail?title_id=1545. Hadler’s book and individual chapters from it are available in e-book or downloadable formats through the Caravan Project www.caravanbooks.org/.

© 2008 Janice Harayda. All rights reserved.
www.janiceharayda.com

August 5, 2008

Remembering August 6, 1945 — Max Hastings

Filed under: Quotes of the Day — 1minutebookreviewswordpresscom @ 5:47 pm
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Max Hastings writes of the day the United States dropped the atomic bomb known as “Little Boy” on Hiroshima in Retribution: The Battle for Japan, 1944–45 (Knopf, $35):

“The detonation of ‘Little Boy,’ the mushroom cloud which changed the world, created injuries never before seen on mortal creatures, and recorded with disbelief by survivors: the cavalry horse standing pink, stripped of its hide; people with clothing patterns imprinted on their flesh; the line of schoolgirls with ribbons of skin dangling from their faces; doomed survivors, hideously burned, without hope of effective medical relief; the host of charred and shriveled corpses. Hiroshima and its people had been almost obliterated, and even many of those who clung to life would not long do so. As late as June 1946, an official press release from the Manhattan Project asserted defiantly: ‘Official investigation of the results of atom bomb bursts over the Japanese cities … revealed that no harmful amounts of persistent radioactivity were present after the explosions.’ Yet even at that date, thousands more stricken citizens of Hiroshima were still to perish.”

© 2008 Janice Harayda. All rights reserved.
www.janiceharayda.com

May 30, 2008

A Totally Unauthorized Reading Group Guide to ‘The Last Lecture’ by Randy Pausch

A Totally Unauthorized Reading Group Guide to ‘The Last Lecture’ by Randy Pausch

10 Discussion Questions
The Last Lecture
By Randy Pausch with Jeffrey Zaslow
Source: One-Minute Book Reviews
http://www.oneminutebookreviews.wordpress.com

This guide for reading groups and others was not authorized or approved by the author, publisher or agent for the book. It is copyrighted by Janice Harayda and is only for your personal use. Its sale or reproduction is illegal except by public libraries, which may make copies for use in their in-house reading programs. Other reading groups that would like to use this guide should link to it or check the “Contact” page on One-Minute Book Reviews to learn how to request permission to reproduce the guide.

After learning that he had terminal pancreatic cancer, Randy Pausch gave an upbeat valedictory lecture at Carnegie Mellon University, where he teaches computer science. He called his talk “Really Achieving Your Childhood Dreams” and explained in it how he had accomplished most of what he set out to do in life. Enlivened with humor and showmanship, his lecture drew millions of visitors to its posting on YouTube and made Pausch a star on the Internet. His talk also inspired The Last Lecture, a collection of short essays written with Wall Street Journal columnist Jeffrey Zaslow, which became a No. 1 bestseller on the New York Times “Advice, How-To and Miscellaneous” list.

Discussion Questions

Please note that the page numbers below come from the large-type edition of The Last Lecture (Thorndike, 2008), the only one available when this guide was prepared.

1. When someone asked what he wanted on his tombstone, Pausch said: “Randy Pausch: He Lived Thirty Years After a Terminal Diagnosis.’” [Page 247] If you were to write his epitaph, what would it say?

2. Summing up a theme of his lecture and book, Pausch writes: “We cannot change the cards we are dealt, just how we play the hand.” [Page 32] This is one of many clichés he admits he loves and uses liberally in The Last Lecture. Did he succeed in making any old ideas fresh? How did he do it?

3. Pausch began his lecture “Really Achieving Your Childhood Dreams” by saying he wasn’t going to deal with big questions of religion or spirituality, and he sticks to that pattern in The Last Lecture. How does the book benefit or suffer from his decision?

4. The Last Lecture recycles much of what Pausch said in his valedictory lecture at Carnegie Mellon and expands some of it. Should people who’ve watched the talk also read the book? Why? What does the book give you that the lecture doesn’t?

5. Pausch could have called his book The Last Lectures, because he structures it as a series of mini-lectures instead of one long lecture. How well does this technique work?

6. The Last Lecture balances general advice such as “dream big” with specific tips – for example, about how to work well in small groups. “Instead of saying, ‘I think we should do A, instead of B,’ try ‘What if we did A, instead of B?’” [Page 190] Which, if any, of the tips struck you as most helpful?

7. Many cancer patients are bombarded with the advice to “be optimistic” or “think positively.” This approach has led to a medical backlash alluded to in the chapter “A Way to Understand Optimism.” Pausch says his surgeon worries about “patients who are inappropriately optimistic or ill-informed”: “It pains him to see patients who are having a tough day healthwise and assume it’s because they weren’t positive enough.” [Page 249] What is Pausch’s view of this? Is he appropriately or inappropriately optimistic? Why?

8. Many people who have heard about The Last Lecture may be tempted to give the book to someone who has had a devastating diagnosis, or who is perhaps dying, hoping it will provide comfort or cheer. What would you say to them? Is this a book for the living or the dying?

9. The Last Lecture comes from Mitch Albom’s publisher and literary agent and has a small format similar to that of Tuesdays With Morrie. These similarities – let’s face it – could be a kiss of death for some people, especially critics who see Albom as an icon of saccharine and dumbed-down writing. What would you say to someone who didn’t plan to read The Last Lecture because, “One Mitch Albom is enough”?

10. If you were going to give your own “last lecture,” what would you say?

Vital Statistics:
The Last Lecture. By Randy Pausch with Jeffrey Zaslow. Hyperion, 224 pp., $21.95. Published: April 2008.

A review of The Last Lecture appeared on One-Minute Book Reviews on May 30, 2008. If you are reading this guide on the home page of the site, scroll down to find the review. If you are reading this guide on the Internet, click on this link to find it www.oneminutebookreviews.wordpress.com/2008/05/30/.

Watch Pausch’s talk “Really Achieving Your Childhood Dreams” and read an excerpt from The Last Lecture at www.thelastlecture.com.

Furthermore: Pausch posts updates on his health at download.srv.cs.cmu.edu/~pausch/news/index.html.

Janice Harayda is an award-winning critic who has been the book columnist for Glamour, the book editor of the Plain Dealer and a vice-president of the National Book Critics Circle www.bookcritics.org.

One-Minute Book Reviews is for people who like to read but dislike hype and review inflation. Totally Unauthorized Reading Group Guides appear on the site frequently but not on a regular schedule. They usually deal with books for which publishers have provided no guides or guides that are inadequate – for example, because they encourage cheerleading for books instead of thoughtful discussion. To avoid missing these reviews, please bookmark the site or subscribe to the RSS feed. If you would like to see the guides continue, it would be extremely helpful if you would link to them.

© 2008 Janice Harayda. All rights reserved.

www.janiceharayda.com

May 21, 2008

Before Ted Kennedy’s Glioma, There Was Johnny Gunther’s

Filed under: Memoirs,News — 1minutebookreviewswordpresscom @ 1:38 pm
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Malignant brain tumors such as Sen. Ted Kennedy’s are uncommon enough that they have received less attention in books than many other types of cancer. One exception to the pattern is Death Be Not Proud, John Gunther’s eloquent memoir of the death of his 17-year-old son, Johnny, from a fatal glioma diagnosed when he was in high school www.oneminutebookreviews.wordpress.com/2008/01/29/. American views of cancer have undergone a sea-change since the book was first published in 1949. But this modern classic remains one of the finest accounts we have of the physical and emotional toll that a malignant brain tumor takes on patients, even those who might seem to have all the advantages.

© 2008 Janice Harayda. All rights reserved.

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