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pp. 449, “Harvard pharmaco-epidemiologist Avorn’s weighty volume authoritatively deconstructs and demystifies the current American prescription-drug debacle, placing it within the larger context of overall medical cost concerns. He frankly discusses what often goes awry when overworked physicians can’t keep abreast of voluminous research, when patients are underinformed about generic drug availability, and when profits provide the sole motivation for pharmaceutical research. Although the U.S. currently outspends other industrialized nations by two-and-a-half times, per capita, for medical care, more than half those nations rank higher in life expectancy, lower in infant mortality. Avorn lays a large portion of blame for those facts at the feet of American capitalism and goes so far as to state that the U.S. doesn’t have a health-care system at all but rather “a collection of lone entrepreneurs, warring conglomerates, cottage industries, aggressive vendors, embattled charities, and isolated consumers–all engaged in hurly-burly piecework transactions.” Rather than simply whining, however, Avorn offers a selection of curative measures to help contain costs while increasing effectiveness. A comprehensive, interesting read.”