Stanford’s pioneering behavioral scientist draws on a lifetime of research and experience guiding the NIH to make the case that America needs to radically rethink its approach to health care if it wants to stop overspending and overprescribing and improve people’s lives.
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 addressing the social, behavioral, and environmental problems that engender disease in the first place. Medicine is important, but many Americans act as though it were all important.
The United States stakes much of its health funding on the promise of high-tech diagnostics and miracle treatments, while ignoring strong evidence that many of the most significant pathways to health are nonmedical. Americans spend millions on drugs for high cholesterol, which increase life expectancy by only 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. Meanwhile, the National Institutes of Health spends just 3 percent of its budget on research on the 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 shakeup in how we invest resources, and it offers a bold new vision for longer, healthier living.
Kaplan…argues that our enthusiasm for biomedical science has inflated health-care costs while encouraging us to neglect more fundamental determinants of ill health, such as behavior and social conditions.
Many Americans are already aware of the extraordinary cost of health care in the United States. This fact is frequently explained away by asserting that such is the price to be paid for the best health care system in the world. Kaplan’s book shatters that comforting myth and exposes the American health care system for what it is: below average in quality and therefore way above average in cost.
More than Medicine makes a clear and compelling case for why America’s overspending on medical care contributes to poor health outcomes. To improve health and well-being in current and future generations, we must heed Kaplan’s call to prioritize financial support for the social determinants of health.
This is the right book, by the right author, at the right time. Kaplan asks a simple question that should concern all of us: why do we spend so much on health but have such poor results? He challenges the fundamental premise that has guided much of American biomedicine for the past half century: that we will achieve health through medical intervention. He makes a convincing argument that we need to think differently—that the promotion of health and prevention of disease should motivate our spending.
From one of the world’s leading experts on public health, a brilliant data-driven examination of the mismatch between the pathways to optimal health and the narrow focus of legacy medicine. More than Medicine offers a new vision to advance health, science, and public policy.
By combining scientific and clinical evidence with rare insight into political funding processes, Kaplan argues persuasively that the vast amount of money we spend on health care is not worth the cost. More than Medicine challenges us to reincorporate the essential element of human care back into medicine.
Sharp, authoritative, and intensely data-driven…The argument is deeply compelling.
Kaplan’s call to ‘rethink’ how health-care costs could be lowered through greater attention to disease prevention and social and behavioral risk factors is worth noting.
- 240 pages
- 5-1/2 x 8-1/4 inches
- Harvard University Press
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