"Since the first edition of Who Shall Live? (1974), over 100,000 students, teachers, physicians, and general readers from more than a dozen fields have found this book to be a reader-friendly, authoritative introduction to economic concepts applied to health and medical care. Health care is by far the largest industry in the United States. It is three times larger than education and five times as large as national defense. In 2001, Americans spent over 12,500 per person for hospitals, physicians, drugs and other health care services and goods. Other high-income democracies spend one third less, enjoy three more years of life expectancy, and have more equal access to medical care. In this book, each of the chapters of the original edition is followed by supplementary readings on such subjects as: "Social Determinants of Health: Caveats and Nuances", "The Structure of Medical Education - It's Time For a Change", and "How to Save 1 Trillion Out of Health Care". The ten years following publication of the 2nd expanded edition in 2011 were arguably more turbulent for US health and health care than any other ten-year period since World War II. They span the implementation of the Affordable Care Act, the deepening opioid epidemic, and the physical, psychological, and socio-economic traumas of the Covid-19 pandemic. An important new contribution to this book is to describe and analyze the changes in five sections: "The Affordable Care Act and the Uninsured", "Health care Expenditures", Health Outcomes", "The Covid-19 Pandemic", and "Health and Politics". This part includes 24 tables and figures. This book will be welcomed by students, professionals, and life-long learners to gain increased understanding of the relation between health, economics, and social choice"--

In recent decades, American medicine has become increasingly politicized and politics has become increasingly medicalized. Behaviors previously seen as virtuous or wicked, wise or unwise are now dealt with as healthy or sick--unwanted behaviors to be controlled as if they were health issues. The modern penchant for transforming human problems into diseases and judicial sanctions into treatments, replacing the rule of law with the rule of medical discretion, leads to the creation of a type of government social critic Thomas Szasz calls pharmacracy. Medicalizing troublesome behaviors and social problems is tempting to voters and politicians alike: it panders to the people by promising to satisfy their needs for dependence on medical authority and offers easy self-aggrandizement to politicians as the dispensers of more and better health care. Thus, the people gain a convenient scapegoat, enabling them to avoid personal responsibility for their behavior. The government gains a rationale for endless and politically expedient wars against social problems defined as public health emergencies. The health care system gains prestige, funding, and bureaucratic power that only an alliance with the political system can provide. However, Szasz warns, the creeping substitution of pharmacracy for democracy--private medical concerns increasingly perceived as requiring a political response--inexorably erodes personal freedom and dignity. Pharmacracy: Medicine and Politics in America is a clear and convincing presentation of this hidden danger, all too often ignored in our health care debates and avoided in our political contests.