Arnold Relman (1923–2014) was Professor Emeritus of Medicine and Social Medicine at Harvard Medical School and a contributor of many articles and essays to The New York Review. Marcia Angell is a Senior Lecturer in Social Medicine at Harvard Medical School. Arnold Relman was her husband.

A Challenge to American Doctors

It is generally agreed that poor and disadvantaged populations, such as teenaged single mothers and their children, or unemployed, uneducated, and ill-housed minorities, suffer relatively poor health. So it might seem entirely reasonable to conclude that the answer to what ails our national health system lies in paying more attention to social welfare programs, preventive measures, and education. Nevertheless, it does not persuade me, and I don’t believe it will satisfy many critics who look closely at the issues.

On Breaking One’s Neck

Arnold Relman in the surgical intensive care unit at Massachusetts General Hospital, the week after his accident. His wife, Marcia Angell, is helping him correct galleys of his August 15, 2013, article in these pages, “Obamacare: How It Should Be Fixed.”
I am a senior physician with over six decades of experience who has observed his share of critical illness—but only from the doctor’s perspective. That changed suddenly and disastrously on the morning of June 27, 2013, ten days after my ninetieth birthday, when I fell down the stairs in my home, broke my neck, and very nearly died. Since then, I have made an astonishing recovery, in the course of which I learned how it feels to be a helpless patient close to death. I also learned some things about the US medical care system that I had never fully appreciated, even though this is a subject that I have studied and written about for many years.

Obamacare: How It Should Be Fixed

President Obama with doctors and nurses at the White House after giving a speech about health care reform, March 2010
The US health care system urgently needs fixing. It is much too expensive and inefficient, and leaves too many people with no care or inadequate care. In March 2010, the recently elected Obama administration barely managed to pass the Affordable Care Act (ACA), a huge and complicated collection of legislative …

A Coming Medical Revolution?

A digital mosaic of the brain, using images from X-rays, CT sans, and MRI scans
Spectacular advances in the scientific understanding of life processes since World War II have vastly increased the ability of physicians to diagnose, treat, and prevent disease. Nevertheless, even today there is much about the cause of most common diseases and their prevention or treatment that remains unknown. However, the huge …

How Doctors Could Rescue Health Care

A nurse consulting a doctor via Mr. Rounder the Robot, Hackensack University Medical Center, Hackensack, New Jersey, 2005
The US is facing a major crisis in the cost of health care. Corrected for inflation, health expenditures in the public sector are nearly doubling each decade, and those in the private sector are increasing even more rapidly. According to virtually all economists, this financial burden, which is now consuming about 17 percent of our entire economic output (far more than in any other country), cannot be sustained much longer.

Health Care: The Disquieting Truth

Joely Richardson and Dylan Walsh in the television series Nip/Tuck
Perhaps the most significant defect in the new health care legislation is that it does not change how medical care is organized, paid for, and delivered. Although stricter regulation or outright elimination of the investor-owned insurance system could save much money, broad reform of the medical care system itself could save even more. To understand what is needed and why requires a closer look at how US medical care differs from that in most other advanced countries, and what makes it so expensive.

The Health Reform We Need & Are Not Getting

President Obama has placed health care reform high on his domestic agenda. He believes that a better health care system is essential for the nation’s economic recovery, so health reform “will not wait another year.” However, he has made only general proposals for reform, leaving Congress to work out the …

McCain, Obama, and the National Health

The current condition of our health care system must certainly be described as serious, if not critical. Until recently, opinion polls had found it at or near the top of domestic concerns. Although it has been displaced by the economic meltdown, there is still good reason to be very worried …

The Power of the Doctors

Social scientists have been perplexed by the remarkably favored position of doctors in American society. Few other professions conduct their affairs with so much autonomy and receive in return such generous economic benefits. In a country historically suspicious of privilege and authority doctors have enjoyed a large measure of both, …