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Since the appearance of Waitzkin's The Second Sickness, a landmark book of the 1980s, American medicine has been dramatically transformed. Waitzkin's earlier edition used qualitative research to take readers inside the ""black box"" of medical decision making. This new, fully updated and expanded edition retains the earlier edition's vivid approach and adds timely analysis of how managed care and other economic and social forces influence medical practice today

The two Koreas—sharing a language, cultural traditions, history of imperial conquest and war, and interrupted family connections—both have mostly succeeded in controlling the pandemic, within different political-economic systems and with markedly different methods.

According to the official narrative of COVID-19, the pandemic has caused the global capitalist economy to collapse, or at least to enter a deep recession and possibly a great depression. Assigning blame to a virus takes attention away from the structural contradictions and instabilities of capitalism that would have led to a crash in any case. This narrative also helps justify non-evidence-based public health policies, including lockdowns, travel bans, closed schools and factories, and forced quarantines of large populations rather than individuals and clustered groups who harbor the infection. Advantages of such drastic measures happen primarily in countries that did not prepare adequately, that did not respond quickly enough with more focused measures to test and isolate people infected with the virus, and that have health care systems either organized by capitalist principles or suffering cutbacks and privatization as a result of capitalist economic ideologies, such as austerity. Authoritarian tactics purportedly intended to protect public health pave the way to antidemocratic rule, militarism, and fascism. These harsh policies also exert their most adverse effects on poor, minority, incarcerated, immigrant, and otherwise marginalized populations, who already suffer from the worsening economic inequality that global, financialized capitalism has fostered.

According to the official narrative of COVID-19, the pandemic has caused the global capitalist economy to collapse, or at least to enter a deep recession and possibly a great depression. Assigning blame to a virus takes attention away from the structural contradictions and instabilities of capitalism that would have led to a crash in any case. This narrative also helps justify non-evidence-based public health policies, including lockdowns, travel bans, closed schools and factories, and forced quarantines of large populations rather than individuals and clustered groups who harbor the infection. Advantages of such drastic measures happen primarily in countries that did not prepare adequately, that did not respond quickly enough with more focused measures to test and isolate people infected with the virus, and that have health care systems either organized by capitalist principles or suffering cutbacks and privatization as a result of capitalist economic ideologies, such as austerity. Authoritarian tactics purportedly intended to protect public health pave the way to antidemocratic rule, militarism, and fascism. These harsh policies also exert their most adverse effects on poor, minority, incarcerated, immigrant, and otherwise marginalized populations, who already suffer from the worsening economic inequality that global, financialized capitalism has fostered.

We have entered a period of history fraught with danger but also rich with revolutionary potential. It is time to move beyond our illusions that electoral politics and reforms of the capitalist state can achieve the revolutionary changes that we all know are urgently needed. As we begin to reorient our struggles there are important lessons to be learned from the recent history of the global South.Click here to purchase a PDF version of this article at the Monthly Review website.

California's drastic Medi-Cal reforms have created great difficulties in health care for the poor. Patients' clinical problems seldom are apparent in descriptions of changes in public insurance programs. Rapidly escalating costs of Medi-Cal led to irresistible pressures for reform, especially from the business community. The new Medi-Cal regulations provide for prospective contracts with hospitals for inpatient services, the transfer of "Medically Indigent Adults" to the responsibility of county governments and various other straightforward funding cutbacks. Confusion, disruption of services and adverse health outcomes have accompanied the Medi-Cal reforms.

As the Affordable Care Act (ACA, otherwise known as Obamacare) continues along a very bumpy road, it is worth asking where it came from and what comes next. Officially, Obamacare represents the latest in more than a century of efforts in the United States to achieve universal access to health care. In reality, Obamacare has strengthened the for-profit insurance industry by transferring public, tax-generated revenues to the private sector. It has done and will do little to improve the problem of uninsurance in the United States; in fact, it has already begun to worsen the problem of underinsurance. Obamacare is also financially unsustainable because it has no effective way to control costs. Meanwhile, despite benefits for some of the richest corporations and executives, and adverse or mixed effects for the non-rich, a remarkable manipulation of political symbolism has conveyed the notion that Obamacare is a creation of the left, warranting strenuous opposition from the right.Click here to purchase a PDF version of this article at the Monthly Review website.