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By Arnold S. Relman, 204 pp, $19.95.
New York, NY, Public Affairs, 2007.
ISBN-13 978-1-5864-8481-1.

JAMA. 2007;298:1338.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In 1980, Dr Arnold Relman wrote about the emergence of the "medical-industrial complex" and presaged its consequences for cost, quality, and access in health care in the United States. History has corroborated his fears. Health care costs now account for 16% of the US gross domestic product, 46 million persons are uninsured, and the quality of care provided at this higher cost is not substantially better (and actually is often worse) than that in many industrialized nations.

As the 2008 elections approach, a number of candidates have voiced grave concerns about the state of health care in the United States, and proposed interventions have emerged for discussion. In A Second Opinion: Rescuing America's Healthcare, Relman warns that recent trends in health insurance could further accelerate the US health care system to its collapse, describes the futility of proposals that would incrementally improve coverage, and pleads for physician leadership toward . . . [Full Text of this Article]

Leonardo Trasande, MD, MPP, Reviewer
Department of Community and Preventive Medicine
Mount Sinai School of Medicine
New York, New York
leo.trasande@mssm.edu

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