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Regush, Nicholas.

Toronto, Macmillan, 1987. 316pp, cloth, $24.95, ISBN 0-7715-9347-3. CIP

Grades 10 and up
Reviewed by David Chadwick

Volume 16 Number 1
1988 January

Nicholas Regush has been a medical journalist for some six years at the Montreal Gazette. Not surprisingly, this book is composed of the short (often only five-or six-page) summaries of issues common to newspaper articles.

Regush is out to create controversy, and the book deals mainly with the problems of accessibility, quality and spiralling costs in the Canadian health system.

Certainly no one would pretend that these are not very serious problems. Regush has enough examples of overcrowding at hospitals, exorbitant costs, and other problems to turn most people's stomachs. He also raises some issues that deserve much more publicity, such as misdiagnosis, the lack of adequate testing or reporting of drugs and new technology, the disparity between rich and poor in terms of life expectancy and general health, and hospitals that don't monitor their spending.

For each issue, the author uses a personal example to illustrate the seriousness of the problem. Regrettably, he does not feel the need to expand documentation by use of footnotes, a bibliography or a note on sources. Thus, the book is more for a general reader looking for topics than for analysis. The book does discuss some of the possible solutions to the medical crisis through better accounting, use of computers, more appropriate use of professionals, and monitoring of equipment, drugs and preventive health care. Surprisingly, AIDS is covered only very briefly, in terms of inadequate funding for research.

While Regush rightly criticizes the wastefulness of many current practices, he ignores the potential lack of accountability of such new practices as the medi-malls. Similarly, he points out some of the progress in Europe but ignores the dangers of private medical care costs for the poor in Britain and the United States.

All in all, Regush has produced a very readable book, which wilt be of interest to anyone concerned with the Canadian medical system. Researchers or professionals will find it a good starting point for discussion and analysis.

David Chadwick, Winnipeg, Man.
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