Ex-Acute, What every American Needs to Know ISBN: 9781514470053, Xlibris, Copyright and written by Dr. Josh Luke.

Apropos its title, this book offers a quite extensive look at the American health system presented in 26 chapters split into 2 parts. Part 1 provides 11 chapters examining “The Fee-for-Service Merry-Go-Round.” It contains some provocatively captioned chapters that when read, amply explain why the author so nicely sums their collective value by a statement opening Part 2; viz. “it is clear that the care we receive is the result of a screwed-up-system with twisted methodologies and incentives between the patient and the provider that are not often aligned.” They are a summation of the system everyone has experienced to some degree if they have had a health problem and attempted to have it resolved. Part 2 continues and contains 15 chapters examining “Lessons from the Field: Assessing Care for Your Aging Parents, Your family and Your Children.” This part provides the reader with details of the evolving system and how best to approach the inevitability of living and/or dying within what is evolving as well as what might eventually evolve. A Glossary, interesting facts About the Author and a few End-Notes conclude the book.

Discussion: This is a book that everyone needs to read, or at least Part 2. Anyone who has experienced a healthcare episode is only too aware of the situation (s) discussed in Part 1, although the author may provide answers to a question or two for which the reader never had been able previously to obtain. The second part presents a cogent discussion of the evolving picture of treatment that the individual must know, along with numerous empathetic suggestions of how to deal with often heart-rending decisions. From this reviewer’s perspective, the only disappointing feature of this presentation is introduction of a particular form of government as the culprit – the repetitive shunting of blame for healthcare’s inadequacies totally to Capitalism. The author most assuredly IS correct about the importance of ‘the-bottom-line’ to many individuals as being rampant. However, because human nature NEVER will allow much more than a modicum of altruism to exert itself regardless of the method of health care being provided, it would seem to be an error to blame the ‘system’ whether it be capitalistic, socialistic or some other provider. My concern with its introduction here is that readers will not concentrate on the importance of his message. Instead, many may pounce upon another factor to add to the growing belief in the need for a more socialistic form of government. Recently Argentina and Venezuela, have shown this form of government has not demonstrated any improvement in healthcare for their countries. Health care under the Russia regimes has been abominable. Great Britain’s record is poor as is that of most other countries in Europe. Interestingly, even Sweden’s top listed health system is again changing because it has been found to suffer the exact problems encountered in the U.S. (Perhaps as a somewhat tangent related aside, in a trip to that country a few years back, I noticed a huge building some distance away and upon enquiry was informed it was one of the largest hospitals in their country and treated only mental patients.) Even Canada’s system is nowhere as adequate as that provided in the United States. Thus, if nothing better is available, that which is provided appears to be better than others touted. Furthermore as the author discusses, better healthcare models gradually are evolving. So, to reiterate and petition the prospective reader, PLEASE do not permit your attention to be redirected to a political theme, when the problem is one with which every form of government has been forced to accept – the existence of only a small amount of personal altruism.

Conclusion: This truly is a must read book for anyone and everyone in the United States who has, is, or will require any level of healthcare. I hope the reader as well as the author will understand and accept my apologies for my reaction to his repeated mentioning inadequacies of a manner of governing as the main culpable reason for the country’s healthcare problems. I sincerely believe that such placement of blame can only add to the horrendously and dangerously chaotic political situation now rampant within the country – one that certainly is not ‘healthy for the country’ nor those living there.

3*    5* Recommended as Must Read; 3* required sincere caveat.