Synopses & Reviews
During her two decades at The New England Journal of Medicine
, Dr. Marcia Angell had a front-row seat on the appalling spectacle of the pharmaceutical industry. She watched drug companies stray from their original mission of discovering and manufacturing useful drugs and instead become vast marketing machines with unprecedented control over their own fortunes. She saw them gain nearly limitless influence over medical research, education, and how doctors do their jobs. She sympathized as the American public, particularly the elderly, struggled and increasingly failed to meet spiraling prescription drug prices. Now, in this bold, hard-hitting new book, Dr. Angell exposes the shocking truth of what the pharmaceutical industry has become and argues for essential, long-overdue change.
Currently Americans spend a staggering $200 billion each year on prescription drugs. As Dr. Angell powerfully demonstrates, claims that high drug prices are necessary to fund research and development are unfounded: The truth is that drug companies funnel the bulk of their resources into the marketing of products of dubious benefit. Meanwhile, as profits soar, the companies brazenly use their wealth and power to push their agenda through Congress, the FDA, and academic medical centers.
Zeroing in on hugely successful drugs like AZT (the first drug to treat HIV/AIDS), Taxol (the best-selling cancer drug in history), and the blockbuster allergy drug Claritin, Dr. Angell demonstrates exactly how new products are brought to market. Drug companies, she shows, routinely rely on publicly funded institutions for their basic research; they rig clinical trials to make their products look better than they are; and they use their legions of lawyers to stretch out government-granted exclusive marketing rights for years. They also flood the market with copycat drugs that cost a lot more than the drugs they mimic but are no more effective.
The American pharmaceutical industry needs to be saved, mainly from itself, and Dr. Angell proposes a program of vital reforms, which includes restoring impartiality to clinical research and severing the ties between drug companies and medical education. Written with fierce passion and substantiated with in-depth research, The Truth About the Drug Companies is a searing indictment of an industry that has spun out of control.
"In what should serve as the Fast Food Nation of the drug industry, Angell, former editor of the prestigious New England Journal of Medicine, presents a searing indictment of 'big pharma' as corrupt and corrupting: of Congress, through huge campaign contributions; of the FDA, which is funded in part by the very companies it oversees; and, perhaps most shocking, of members of the medical profession and its institutions. Angell delineates how the drug giants, such as Pfizer and AstraZeneca, pay physicians to prescribe their products with gifts, junkets and marketing programs disguised as 'professional education.' According to Angell, the cost of marketing, both to physicians and consumers, far outweighs expenditures on research and development, though drug makers invoke R&D as the reason drug prices are so high. In fact, says Angell, with combined 2002 profits of $35.9 billion for the Fortune 500's top 10 drug companies, the drug industry is America's most profitable by far, thanks to disproportionately high prices, generous tax breaks and manipulation of patents to extend exclusive marketing rights to blockbuster drugs like Prozac and Claritin. Angell mounts a powerful case (and offers specific suggestions) for reform of this essential industry a case worth bearing in mind as 'big pharma' continues to oppose importing cheaper drugs from Canada. Agent, Martel Agency. (On sale Aug. 24) Forecast: Time called Angell one of the 25 most influential Americans, and with the high cost of drugs making front-page news, her book should find a receptive audience." Publishers Weekly (Copyright 2004 Reed Business Information, Inc.)
"[A]n impassioned expose....Every registered voter should read this book; highly recommended." Library Journal
Jeff Selingo, journalist and editor-in-chief of the Chronicle for Higher Education, argues that colleges can no longer sell a four-year degree as the ticket to success in life. College (Un)Bound exposes the dire pitfalls in the current state of higher education for anyone concerned with intellectual and financial future of America.
What is the value of a college degree?
The four-year college experience is as American as apple pie. So is the belief that higher education offers a ticket to a better life. But with student-loan debt surpassing the $1 trillion mark and unemployment of college graduates at historic highs, people are beginning to question that value.
In College (Un)bound, Jeffrey J. Selingo, editor at large of the Chronicle of Higher Education, argues that Americas higher education system is broken. The great credential race has turned universities into big business and fostered an environment where middle-tier colleges can command elite university-level tuition while concealing staggeringly low graduation rates, churning out graduates with few of the skills needed for a rapidly evolving job market.
Selingo not only turns a critical eye on the current state of higher education but also predicts how technology will transform it for the better. Free massive online open courses (MOOCs) and hybrid classes, adaptive learning software, and the unbundling of traditional degree credits will increase access to high-quality education regardless of budget or location and tailor lesson plans to individual needs. One thing is certain—the Class of 2020 will have a radically different college experience than their parents.
Incisive, urgent, and controversial, College (Un)bound is a must-read for prospective students, parents, and anyone concerned with the future of American higher education.
About the Author
JEFFREY J. SELINGO is the leading authority on higher education worldwide and editor at large for The Chronicle of Higher Education. He frequently speaks before national higher-education groups and appears regularly on regional and national radio and television programs, including NPR, PBS, ABC, MSNBC, and CBS. His writing on higher education and technology has appeared in the New York Times, the Washington Post, and the Huffington Post. The National Magazine Awards, Education Writers Association, Society of Professional Journalists, and the Associated Press have recognized him for his work. He is a senior fellow at Education Sector, an independent education policy think tank. www.jeffselingo.com
Table of Contents
HOW WE GOT HERE
1. The Great Credential Race 3
2. The Customer Is Always Right 19
3. The Trillion Dollar Problem 35
4. The 5 Disruptive Forces That Will Change Higher Education Forever 55
5. A Personalized Education 73
6. The Online Revolution 86
7. The Student Swirl 105
8. Degrees of Value 122
9. The Skills of the Future 142
10. Why College? 160
The Colleges of the Future 184
Checklist for the Future 207
About the Author 225