Unnatural History: Breast Cancer and American Society

author touches upon issues associated with " opting-out " of universal coverage to accept " customized " private services. A detailed econometrics exercise is then performed to determine the impact of " de-listing " services from a universal health plan. Other issues, such as the allocation of a doctor's time for private vs. public service and the ethics of private insurance marketing in a universal healthcare market, are covered as well. The rest of the chapters focus on consumer directed healthcare (CDHC), medical savings accounts (MSAs), and economic incentives. With complex economic models, the author argues that high-deductible (HD) plans result in a stronger " illness prevention " behavior than a conventional plan. The author also highlights that individuals with low likelihood of illness are more likely to choose HD plans. The next chapter highlights the introduction of MSAs within the United States, Singapore, and China, and the role MSAs would play in public spending and saving in Canada. The concepts of " demand side incentives " and " supply side incentives " are introduced to highlight the role of patient and provider incentives. The book expands these concepts to include physician, health plan, and provider incentives. The author concludes that health services in Canada are, for the most part, equally balanced between poor and rich socioeconomic groups. However, for services not covered under the universal plan (i.e., dental), there is strong evidence that supports unequal coverage among socioeconomic groups, and despite equal coverage between socioeconomic groups, lower income populations are in worse health overall than higher income populations. A particular strength of this work is its ease in organization. Each section is clearly titled and defined, allowing the reader to scan the book quickly to retrieve information of particular interest. The graphs, economic charts, and tables are clear and relevant, adding breadth to the text, which contains detailed, technical information to support the economic concepts. A downside is the style of writing varies drastically from chapter to chapter. Some sections of chapters contain high level executive summaries that are clear and easy to read. Other sections dive deep into the underlying economic theory that supports the health policy, which could challenge any reader who hasn't pursued advanced study in economics and/or mathematics. An interesting surprise about this compilation is its focus around the Canadian universal healthcare system. The readings gave an interesting perspective about the potential inefficiencies and inequities …