PROGRAM

Roosevelt House is pleased to present a discussion of The Present Illness: American Health Care and Its Afflictions by physician, health services researcher, and professor of medicine Martin F. Shapiro. In this eye-opening and powerful assessment of the state of medicine in the United States, Shapiro goes beyond political posturing and industry quick-fixes to address the all-important question: why is the American health care system so difficult to reform?

Weaving together history, sociology, extensive new research, and Shapiro’s own experiences as a physician, The Present Illness explores the broad range of afflictions impairing US health care and explains why the system cannot be fixed without significant changes across society. In doing so, Shapiro delivers a powerful assessment of the many ways in which individuals and institutions help to shape and reinforce a dysfunctional system—placing responsibility not just with clinicians, medical schools, and hospitals, but also with scientists, insurers, manufacturers, governments, and even patients and the public.

With a sharp eye and ready humor, Shapiro identifies three major problems that stand in the way of needed reforms: commodification of care; values, expectations, unmet needs, attitudes, and personal limitations of participants; and toxic relationships and communication among these groups. From there, Shapiro lays out a sweeping agenda of concrete actions to address the many factors contributing to the system’s failings. Highlighting the interconnectedness of both the problems and potential solutions, The Present Illness warns that piecemeal reform efforts will continue to face challenges from those who have something to gain from the status quo. Shapiro nonetheless concludes that we must push forward with a comprehensive effort in all sectors of health care—and throughout society—to create a system that is humane, effective, and just.

Martin F. Shapiro, MD, PhD, MPH, is a physician, health services researcher, and a professor of medicine at Weill Cornell Medical College and Distinguished Professor Emeritus of Medicine and Public Health at the University of California, Los Angeles, where he was chief of the Division of General Internal Medicine and Health Services Research for 25 years. He is the author of Getting Doctored: Critical Reflections on Becoming a Physician.