This is an auto-narrated audiobook edition of this book.
There is little debate that health care in the United States is in need of reform. But where should those improvements begin? With insurers? Drug makers? The doctors themselves? In Big Med, David Dranove and Lawton Robert Burns argue that we’re overlooking the most ubiquitous cause of our costly and underperforming system: megaproviders, the expansive health care organizations that have become the face of American medicine. Your local hospital is likely part of one. Your doctors, too. And the megaproviders are bad news for your health and your wallet.
Drawing on decades of combined expertise in health care consolidation, Dranove and Burns trace Big Med’s emergence in the 1990s, followed by its swift rise amid false promises of scale economies and organizational collaboration. In the decades since, megaproviders have gobbled up market share and turned independent physicians into salaried employees of big bureaucracies, while delivering on none of their early promises. For patients this means higher costs and lesser care. Meanwhile, physicians report increasingly low morale, making it all but impossible for most systems to implement meaningful reforms.
In Big Med, Dranove and Burns combine their respective skills in economics and management to provide a nuanced explanation of how the provision of health care has been corrupted and submerged under consolidation. They offer practical recommendations for improving competition policies that would reform megaproviders to actually achieve the efficiencies and quality improvements they have long promised.
This is an essential read for understanding the current state of the health care system in America—and the steps urgently needed to create an environment of better care for all of us.
This is an auto-narrated audiobook version of this book.
The story of how a biologically driven understanding of gender and sexuality became central to US LGBTQ+ political and legal advocacy.
Across protests and courtrooms, LGBTQ+ advocates argue that sexual and gender identities are innate. Oppositely, conservatives incite panic over “groomers” and a contagious “gender ideology” that corrupts susceptible children. Yet, as this debate rages on, the history of what first compelled the hunt for homosexuality’s biological origin story may hold answers for the queer rights movement’s future.
Born This Way tells the story of how a biologically based understanding of gender and sexuality became central to LGBTQ+ advocacy. Starting in the 1950s, activists sought out mental health experts to combat the pathologizing of homosexuality. As Joanna Wuest shows, these relationships were forged in subsequent decades alongside two broader, concurrent developments: the rise of an interest-group model of rights advocacy and an explosion of biogenetic and bio-based psychological research. The result is essential reading to fully understand LGBTQ+ activism today and how clashes over science remain crucial to equal rights struggles.
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