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Presents a physician's perspective of America's current medical system and recent attempts to reform it. Orient (Executive Director of the Association of American Physicians and Surgeons) reviews the pros and cons of the Canadian, British and German health-care systems and analyzes the emerging managed health-care plans. She believes such plans accelerate the rise in medical costs, and advocates free-market reform strategies and a decrease in government regulation. Annotation c. by Book News, Inc., Portland, Or.

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Publishers Weekly Review

The current debate over health care reform has created a brisk market for information, and Orient, the executive director of the Association of American Physicians and Surgeons, here weighs in with the conservatives on health care reform, arguing that ``a free market would bring the best possible medical care to the greatest number of people at the lowest possible cost.'' The book makes the case for freedom of enterprise and inquiry in medicine--a system under which the ``heart of medicine is the relationship of one doctor to one patient.'' Orient believes that the medical profession is already over-administered and controlled, like a ``patient who suffers from polypharmacy.'' She predicts the further enslavement of physicians should a nationalized system emerge. Her descriptions of the British and German models of socialized medicine (both of which permit private insurance and private medicine) and the Canadian system are used to point out the flaws in state-run medicine. According to the author, the ultimate result of most reform plans would be ``the destruction of our traditional forms of medical practice.'' Whether or not you agree that health care is a privilege and not a right, and that the proposed changes will mean less freedom, this thought-provoking defense of private medicine should be read by all interested in the health care dialogue. (May) (c) Copyright PWxyz, LLC. All rights reserved

CHOICE Review

Orient's book might be considered the physician's response to the possibility of establishing a national health care system in the US. In it, Orient (executive director, Association of American Physicians and Surgeons) presents the case against national health care. Although clearly biased in favor of the existing system and extremely biased against the proposed national system, the book should be read by everyone with an interest in the issue because of the eloquent argument from a physician's perspective. The book is full of interesting anecdotes that Orient apparently believes to be evidence that a national system would be destructive to liberty and freedom, in addition to weakening the system of health care for most Americans. Some of the anecdotes, however, indicate the need for such a system. Recommended for health professionals, students in the various health professions, and anyone with an interest in this important topic. M. Kaufman; Westfield State College

Booklist Review

The paradox that universal health care means restricted health care is validated by evaluating the state of British, Canadian, and German health-care systems. Closer to home, Orient examines the consequences of third-party payer systems in the U.S., which now wield control over the quality of health care provided by VA hospitals and HMOs/PPOs, and by independent physicians to Medicare/Medicaid or privately insured patients. Although the public is generally unsympathetic to the plight of doctors beleaguered by third-party regulations, the effects of bureaucratic second-guessing on patient care demand critical consideration, which Orient provides anecdotally. Particu~larly alarming potential side effects of national health care, such as compromised medical privacy in this time of AIDS and other sexually transmitted diseases, and, chillingly, involuntary euthanasia, are discussed. Orient presents her concerns convincingly, with a touch of wry humor that lightens but does not diminish such worrisome prospects. ~--Brenda Grazis