Book

Unhealthy Politics: The Battle over Evidence-Based Medicine

Photo of the cover of the book titled "Unhealthy Politics"

Alan S. Gerber, the Charles C. and Dorathea S. Dilley Professor of Political Science; Eric M. Patashnik, the Julis-Rabinowitz Professor of Public Policy and Political Science at Brown University; and Conor M. Dowling, associate professor of political science at the University of Mississippi

(Princeton University Press)

The U.S. medical system is touted as the most advanced in the world, yet many common treatments are not based on sound science, the authors contend. Treatments can go into widespread use before they are rigorously evaluated, and every year patients are harmed because they receive too many procedures — and too few treatments that really work. “Unhealthy Politics” sheds new light on why the government’s response to this situation has been so inadequate, and why efforts to improve the evidence base of U.S. medicine continue to cause so much political controversy and public trepidation.

This book draws on public opinion surveys, physician surveys, case studies, and political science models to explain how political incentives, polarization, and the misuse of professional authority have undermined efforts to tackle the medical evidence problem and curb wasteful spending. It paints a portrait of a medical industry with vast influence over which procedures and treatments get adopted, and a public burdened by the rising costs of health care yet fearful of going against “doctor’s orders.” The book shows how the government’s efforts to promote evidence-based medicine have become mired in partisan debates. It also proposes solutions that can lead to better, more efficient health care for everyone.