Solid, clearly written, and mercifully short primer on the health care system written from a thoughtful pro-market perspective. If this were requireed reading for all commentators on health care policy, we would hear a great deal less nonsense. It does not, alas, contain my favorite Kling zinger "20% of the costs cannot be 100% of the problem" (re: high pharmaceutical prices.)

4.5.07 [in deference to the title , I finished this book in a shopping mall while waiting for someone to finish trying on clothes] ( )

For this reader, Crisis of Abundance by Arnold Kling was difficult to read. Fortunately, it is very short, under 100 pages. In the end, it was well worth my brief persistence.

Anyone who wants to understand the healthcare crisis in the U.S. would benefit by reading this. The author is an economist, and the book is clearly told from an economic and public policy perspective. His goal was to write this book for the "concerned citizen," while at the same time making it credible to professional economists (p. ix). I rank this book lower than most other reviews because I believe the author partially fails in his attempt to write this book clearly for the concerned citizen.

He makes the point that what ails our national health care system is what he calls premium medicine—or health care spending whose cost exceeds its benefit. He defines premium medicine as: "frequent referrals to specialists; extensive use of high-tech diagnostic procedures; and increased numbers and variety of surgeries" (p. 4). "If our high levels of health care spending are the result of so-called premium medicine, we should be demonstrably healthier. Yet when we attempt to examine average longevity at a national level, there seems to be no connection between American's high levels of health care spending and life span." (p. 25)

I found the book most difficult when the author was presenting policy issues. Kling states that his goal is "not to offer a package of solutions. It is to raise the level of understanding of the realities, issues and tradeoffs pertaining to health care policy" (p. 95). Here, for this reader, he succeeded. I now have a far better grasp of why the U.S. spends so much more on health care than other developed nations.

Kling is a libertarian, as is my husband, and that is how the book ended up in my hands. Generally I don't like libertarian solutions to today's problems, but I found this book far less ideologic than others my husband has shared with me.

The book has piqued my interest, and I will no doubt read more on this topic in the future. Personally, I would love to find a book on this topic that also takes the environmental costs (see for example, Plan B 2.0 by Lester Brown) of premium medicine into consideration when discussing the cost-benefit equations. Now that would be challenging and controversial! ( )