Book Title: Code Blue

Author: Mike Magee

Publication Information: New York, Atlantic Monthly Press, 2019, 422 pp., $27 hardcover, $18 paperback

Code Blue, by Mike Magee, MD, takes a unique approach to promoting a single-payor system by examining our current health care system through the lens of history. Dr Magee has practiced medicine as a urologist and participated in government agencies and the pharmaceutical industry, most notably as the physician face of Pfizer during the release of Viagra in the late 1990s. As a true insider, he has a unique perspective on the US medical system.

Magee introduces the term “medical industrial complex” to describe the elaborate and often profit-focused interplay between the insurance industry, pharmaceutical industry, political machinery at work for the American Medical Association and other agencies, pharmacy benefit managers, and academic institutions.

Code Blue weaves a brilliant tapestry of the history of the medical industrial complex. For example, he examines the pharmaceutical industry and its evolution from the primordial ooze of snake oil and cocaine to its present-day curative focus. He discusses the negative effects of direct-to-consumer advertising, unsavory marketing techniques like prescription profiling of clinicians, and publication bias, noting that “industry-funded studies were positive 85% of the time, compared to positive results in only 50% of the government-funded studies” (p 230). He examines major personalities that helped to create the system, including physician-turned-businessman and philanthropist Arthur Sackler as the “ultimate manipulative marketer” (p 150).

Cure versus care is also a major dichotomy addressed in the book. Magee points out that the sense that we, as a medical community, will fix or cure all ills often interferes with caring. Funding for the next wonder drug seems ever present from NIH sources, while funding for basic bench research and public health is minimal.

Since the idea of a single-payor system has become a politically charged issue, it is expected that the author would exhibit some political bias. While the author shares his political views throughout the book, these do not detract from the overall value of the book or the validity of the arguments made.

I suspect many of us in family medicine, along with clinicians in other specialties, have mixed feelings regarding a single-payor insurance system in the United States. It has become a hot topic lately as presidential democratic party primaries are underway at the time of this writing. Code Blue assaults our current medical system with a thorough examination of its history, allowing the relationships and events of the past to speak for themselves. It is a worthwhile read for anyone confronted with the challenges of clinical practice and searching for an answer to the questions, “How did we get here?” or “What do we do next?”

Pharmacy Professional on CODE BLUE

Arianna Huffington Ranks CODE BLUE #1!

https://www.kirkusreviews.com/book-reviews/mike-magee/code-blue-medical/
CODE BLUE discussed by ABC News Cheri Preston on Perspective podcast at minute 22 @ https://lnkd.in/eBGUCcZ
http://www.startribune.com/review-code-blue-by-mike-magee/510763462/
NEW SCHOOL Professor of Economics Richard D. Wolff

Professor Wolff says that “CODE BLUE is the book you want to read. Listen to his interview of Mike Magee beginning at minute 15 @ https://lnkd.in/e8Fw6hi

FROM CUSTOMERS

GOODREADS REVIEWS:

Shelly

Feb 25, 2019 Shelly rated it it was amazing. Everything you should know about the Medical Industrial Complex in the United States in one riveting book! As a physician, former hospital administrator and former pharmaceutical executive, author Mike Magee takes us into the corporate world of one of the most complicated and costly industries in the US. This book dives into the history, context, back story, key players, legislation, competition and collusion that have shaped the nation’s present-day health care industry. Although there is quite a lot of content, this is anything but a dry read. It is insightful and thought-provoking. less)flag6 likes · Unlike  · 1 comment · see review

Dan Connors

Aug 16, 2019 Dan Connors rated it really liked it. As one who has luckily avoided the medical industrial complex for the most part, I still wonder how we got where we are with American health care, and why it’s considered one of the worst systems in the world while also being the most expensive.

Dr. Magee is an expert in his field, and he showcases his experience at Pfizer during the Viagra gold rush. If you’ve been paying attention the past 20 years, you will recognize the names and changes that have made our system both dysfunctional and excellent, depending on luck and circumstances.

The medical industrial complex, as Dr. Magee calls it, consists of medical professionals, insurance companies, hospitals, big pharma, government and universities, all of whom collude with each other to protect their turf and maximize profitability.

The book dives into some of the history of how we got here, and how groups like the American Medical Association, Food and Drug Administration, Medicare, and the employer based health insurance system got their starts. One thing I didn’t know was that after World War II, when the American government was helping rebuild Germany and Japan, they helped both countries establish public health insurance, while at the same time squashing it here at home as “socialized medicine.” Presidents as diverse as Harry Truman, Richard Nixon, Bill Clinton and Barack Obama all tried to establish some sort of government health insurance like has emerged in all other industrialized countries, only to be beaten back by the medical industrial complex every time.

What’s always puzzled me is how what we now know as Obamacare was actually dreamed up by the Republican party decades earlier. Now that same party is trying to destroy the Affordable Care Act with no clear alternatives being discussed.
More points brought up in the book:

– Advocacy groups like the American Cancer Society are funded by industry and more geared to heroic cures than to prevention.
– The people who monitor and evaluate hospitals are not independent. Hospitals can be very secretive about their prices and their accidental death rate (which has been going up according to the book.)
– Drugs for ADHD (ritalin and adderal) and Pain (opiods) are recommended by doctors and commercials way too much for minor conditions, with the result that the profit motive trumps sound healthcare. The author warns that all drug advertising and free samples to doctors should be stopped.
– Universities and researchers are beholden to the MIC, and have been known to stretch ethical boundaries with tests on human subjects and fudging their data to get the right result.
– Enormous amounts of health care dollars are spent on bureaucracy. For every physician there are 16 workers in the system, half of which add no clinical value at all.
– In order to pass health care reform, Obama had to agree not to negotiate drug prices or allow imports, leading to the scenario today where drugs in the US are often 10 times as expensive as the same drug in other countries.

The final chapter of the book lists reforms that the author thinks would help the health care system catch up to the rest of the world (where he claims we are number 50 of 55 comparable countries in overall health.) The big reform, which has been discussed by many, would be some kind of single payer, government based healthcare that would eliminate the middlemen and rein in the profiteers.
After watching this debate for most of my life, I’m not too hopeful because the current system is so entrenched, but I highly recommend this book to those in the healthcare field and those who use the system regularly. (le

Donna Hines

Jan 05, 2019 Donna Hines rated it it was amazing. One of the most extensive yet interesting books I’ve read to date on this subject matter.
Mike Magee opens up about the greed, the collusion, the profitability factors, the fleecing of America in the name of dollars and cents.
Personally this hits home as I suffer from a variety of ailments requiring medical treatment on a regular basis and have seen the attempts to get America hooked on drugs.
For example I’ll show two of the most recent:
1. Pertained to childbirth pain from a high risk section in which I was offered repeatedly oxycontin like candy. You know the famous nurse’s line: Just press the button if you need it!
2. When I was younger ADHD was not the phenomenon money maker it’s now. It was often treated with medicine such as Ritalin but it was glamorized like today. Now if you can’t sit still it’s offered without hesitation. Thankfully my mother declined not knowing the risks and I’m forever grateful she did. I have always been hyperactive with that constant need to keep moving at all times. I function fine and can’t imagine what these god awful drugs are doing to our children. In fact I graduated with top honors, inducted into national criminal justice societies, and graduated with MPA/CJ degree with Points of Light Award from Pres. George HW Bush in 16 all with ADHD.
Folks today want a quick fix and will do anything for it.
Buyer beware especially with regards to meds as you honestly don’t know the reasoning behind the fleecing until deaths occur.
Sadly we now have an epidemic with opiods and pain killers among others such as Viagra and it’s all for profit.
It’s sad that America has become the guinea pig for corporate and or individual greed.
Please do yourself a favor and read this book in its entirety.
As a mother of a son born with Vater Syndrome who went code blue and who knows every hospital code over the years of his extensive treatment I urge everyone to get a copy and crack this open.
You won’t regret you did!
The best way to stop the problem is to educate oneself as ignorance is not an excuse.
Protect yourself, know your body, know your limits.
Thank you to Mike, the publisher, NetGalley, and Aldiko for this ARC in exchange for this honest review.
A real eye opener in more ways than one! 

Jeanne

Aug 25, 2019 Jeanne rated it really liked it. This should be required reading…. not a fun read, but ever so important. It gives the historical context for the major issues in our healthcare system, and probably society in general. The collusion of the medical industrial complex, focus on cure over care, and plain greediness are themes throughout this book. Hopefully single payer and checks on the medical industrial complex can become reality, along with meaningful and safe development and cost containment as our population ages.

Nina

Mar 06, 2019 Nina rated it it was amazing. This book explains the history of the medical agencies, organizations and associations, governmental, for-profit and nonprofit that have exerted influence to create the healthcare system we have today. The roles of the three most powerful sources of influence, hospitals, insurance companies and pharmaceutical companies are described at length. The author, as a medical doctor who has worked for Pfizer and universities and hospitals, has the experience and inside information that gives this account a wealth of credibility. He offers a variety of solutions at the end. This book is such an eye opener you will never look at healthcare the same way again. It should be required reading for all medical students.

Brian

Jun 26, 2019Brian rated it it was amazing. Code Blue by Dr. Mike Magee takes a look at the idea of a Medical Industrial Complex akin to the Military Industrial Complex that President Eisenhower warned of. This complex is made up of Hosptials, insurers, pharmacists, professional medical organizations, and government entities including but not limited to the FDA, NIH and members of congress. This group has shaped and destroyed American health care by putting profits ahead of practice, disease research ahead of managed health and a pursuit that has led to sub optimal outcomes in health care. While it is clear that Mike Magee believes a single payer is the only way out he lays out his reasoning carefully and soundly. While I would like to believe there is a more free market way out that puts the labor market back on the onus of providing employer based health insurance as we proliferate right to work states that seems to be less and less likely. The author hear knows his topic well having been a physician, worked for Pfizer and then as a policy analyst writing on the topic of health care in America.
This book is well researched and for those who want an informed opinion of how we got to where we are this is a very good place to start. With my own background in health and pharma economics I found this a fascinating read and largely jived wit he macro data I have studied on health care trends. In short for 300 pages the author covers a tremendous amount of ground accurately and succinctly with thoughtful analysis that bears closer study.

Becky Loader

Aug 13, 2019 Becky Loader rated it liked it. Magee pulls no punches in his well-documented book on the health industry. It is depressing, though.

Bob H

Mar 24, 2019 Bob H rated it it was amazing. A detailed, and damning, look at what Dr. Magee calls the Medical-Industrial Complex, the manufacturing, marketing and lobbying groups that, through the 20th Century and into the 21st, made American medicine into the expensive monster that it is today, albeit delivering lower life expectancy than much of the developed world. We learn, indeed, that it is a drag on American prosperity, “the tapeworm of American economic competitiveness” with its expenses and cost-ineffectivity.

There’s more, however, and Dr. Magee shows us some of the more egregious examples: the early trend of aggressive marketing by pharmaceutical companies, who deployed legions of salesmen to doctors’ offices with incentives and free samples when the drugs’ damaging (or sometimes lethal) side-effects were not fully known, as well as more marketing by groups like the AMA against government efforts like national health care in Truman’s day, and against Medicare a generation later. We see the culture of “big ticket research and development” instead of a combined health plan, and the institutional distortions at agencies like the National Institutes of Health. We see the use of medical research as a screen for the tobacco industry.

The book, more and more, focuses on abuses in pharmaceuticals, since medicine is often pill-driven. The appearance of ADHD as a known syndrome would prompt hyping of drugs such as benzedrine, and, later, Ritalin and Adderall as over-used, and profitable, cure-all nostrums.

The book is especially timely now (spring 2019) with a major new lawsuit against Purdue Pharmaceuticals and the Sackler family. Dr. Magee shows how much industry lobbying and hype overall had contributed to the opioid epidemic, one that would leave a trail of addiction and thousands of deaths. Dr. Magee also talks about the offshoring of unproven or untested therapies and drugs in Third-world countries like Nigeria, a situation hinted at in the book and film “The Constant Gardener.” He also tells of the promotional and institutional changes wrought by the Viagra marketing craze.

There’s more: the encroachment of “faith based” health policy, notably during the HIV/AIDS epidemic and a convenient alliance between AIDS activists and pharmaceuticals to rush drug treatments. We see more religious opposition in fields like stem cell research.

Finally, we learn of some surprising alliances between advocacy groups and the industry, first in pushing Medicare Part D, and later, Obamacare.

It’s a sordid, infuriating and illuminating work by a physician who had worked in hospital administration, and then in a senior position at Pfizer. And it’s timely. Highest recommendation.

(Reviewed in advance reading copy by Amazon Vine.) 

Ed Bernard

Sep 19, 2019 Ed Bernard rated it it was amazing. A comprehensive indictment of the American system of health care by someone who should know — Magee has been a working physician AND an executive of a large pharma company (Pfizer) so he knows a couple of sides of this convoluted, deeply screwed up narrative personally. He skewers what he calls the Medical Industrial Complex thoroughly — its history, the self-serving and shameful conduct of the AMA, the unholy alliance between researchers and drug companies, all of it. Here are two random facts that should outrage everyone: 1) as part of the Marshall Plan, the US outfitted our two most significant foes in WWII (Germany and Japan) with a shiny new healthcare system that operated from the assumption that a healthy citizenry was essential for a functional first-world nation, and thus made a system that was both affordable and effective. When Truman tried to implement the SAME system in the US, resistance from the AMA (the first to label a government operated single payer system “socialized medicine,” a legacy that still haunts today) scuttled the plan. Which leads to fact 2) the US has by far the highest health care costs in the world … and our outcomes are the worst — by one count, 15th out of 15 nations. Since the 40’s, the drug companies have become rich and powerful as well, so we now have absurdities like American drug companies exporting drugs to Canada, where Canadians pay far lower prices because the costs are negotiated by the government, not for-profit insurers … AND, American providers can’t re-import these drugs on the ridiculous premise that the FDA can’t ensure that they are safe and effective. Our own drugs! It’s just nuts. Who knew health care was so complicated (to toss a gratuitous jibe at Donald Trump … sorry, it was just sitting there teed up, gotta take a swing at it)? McGee offers a few ideas to get us out of this mess which seem fraught with either existential problems or unlikely to solve much, but it hardly even matters — the core of this book is his scathing indictment of the MIC and he handles it with clarity, equanimity and engaging narratives. Just a brilliant book that everyone should read.

Grade: A

Julie Stielstra

Jul 22, 2019 Julie Stielstra rated it really liked it. Pretty much everyone agrees the American healthcare system (if you can even call it that) is broken. Badly broken. Mike Magee is here to tell you how it got that way, and it’s worse than you imagined. Decade upon decade of collusion (yes! collusion!), connivance, coverups, downright criminal behavior, politicking, horse-trading, lies and more lies are the core ingredients of what Magee calls the Medical-Industrial Complex, the cabal of insurers, pharma executives, trade associations, academic and research institutions who have all joined hands (and sometimes fought, changed sides, made up, then fell out again) in pursuit of… public health? better medical care? high-tech disease-curing breakthroughs? care for the poor, the elderly, the sick? Uh-uh. Money. It’s ALL about the money.

He knows whereof he speaks, having been a very successful part of it for much of his career as a physician, educator, hospital administrator, and finally a high-level honcho at Pfizer Pharmaceuticals. This is where I can’t shake off some queasiness about why, if it was so bad and he knew it, how come it took him so long to get out? Nevertheless, this is a detailed, damning, closely referenced account of the nightmare.

It is enlightening to read the blazing criticism of Medicare when it was proposed in the early 60’s… because it uses the same language and tactics we heard about the Affordable Care Act under Obama, and that we hear daily today about any alternative system being proposed. And guess what? Medicare worked out quite nicely, thank you. The chapter on the opioid crisis doesn’t describe much more than we already know… except for the back room, shell-company, sweetheart dealings expertly managed by the likes of the Sacklers.

Vivid, appalling, and very very important. Read it. 

Anne

May 26, 2019 Anne rated it it was amazing. Is the problem with health care in America caused by its being a profit driven business?
Is healthy business in direct competition with providing health care for all citizens?
“The AMA serves the financial interests of its members, not primarily the health and well-being of the American people.” Does this compromise the quality and cost of health care in our country? These issues and more are covered by a former industry insider and medical doctor. This is an interesting study of the Medical Industrial Complex and what many believe is a serious problem in our country today.

“The American system of [pharmaceutical] research is rife with unethical conduct and financial conflict of interest…studies have been conducted in underdeveloped countries on “children who were often gravely ill, undernourished and highly vulnerable…and where medical personnel have been really badly taxed.” These are major pharmaceutical companies with recognizable names and an industry driven by a profit motive.

“As Americans bear the brunt of high cost and low performance, every other developed nation far exceeds our rate of progress in dealing with such basics as infant mortality, immunizations, infectious disease rate, malnutrition, and sanitation.”

This book is for anyone who wants to take a peek behind the curtain of the medical establishment. The author is a knowledgeable industry expert and uses verifiable statistics and studies all well documented in endnotes. He closes the book with a multi-point plan to reform the existing medical coverage in this country. 

HollyLovesBooks

Aug 02, 2019 HollyLovesBooks rated it it was amazing. This is such an important book looking at an insider’s view (from multiple perspectives) of the medical industrial complex. Some may complain or moan that Dr. Magee is selling the medical community or administrators out by telling this story but it needs to be publicly told. In this day and age, when our country, as wealthy as it is, has such awful statistics in the healthcare sector for easily preventable conditions, we need to know these facts. Washington, D.C. politics are too busy vying for power and not representing the needs of Americans when it comes to many issues, but healthcare is one that will universally affect each and every one of us.
Wake up people! Everyone dies! Therefore, preventing disease is important. Treating disease early is important. Having easy access to high quality care is important. Instead we are allowing decisions to be made by the MIC that will ultimately affect our ability to access these services (and for providers to provide them).
Thank you Dr. Mike Magee for this timely and comprehensive book outlining the background and conversation we need to be having in this country now about how we want our healthcare to be for the coming years and why it became the way that it is now.

Highly recommend!!
#CodeBlue #NetGalley

Andrew Degruccio

Jun 23, 2019 Andrew Degruccio rated it it was amazing. Giving this 5 stars because it is a must read for anyone who thinks they understand the complexity of the medical industrial complex. I think Dr. Magee covered a lot of ground in just over 300 pages. Sure some glossing over topics and jumping from topics occurs, but that was simply in an obvious attempt at brevity while preserving a complete coverage of the disaster that is American medicine. He gives great guidance on fixing the system. The importance of many of his recommendations may be lost on those not caught up in the medical industrial complex, but I found them all to be well thought out. Well done. 

Robert Patterson

Aug 09, 2019 Robert Patterson rated it really liked it. Riveting. Gives an entire overview, historical, contextual, over what Dr Magee who as a former Dr, hospital administrator, Pfizer executive and heath sector veteran dubs the Medical Industrial Complex. Convincing, thorough and engaging in a complex topic.
The insider take on the profits of all sectors over health benefits showcases why the US lags behind developing countries in health outcomes while costing 2x 3x more than other developed countries.

Frustrating.

Nathan

Dec 07, 2019 Nathan rated it it was amazing. Anybody involved in the medical field, no matter how deep nor minor, needs to read this book. Incredibly enlightening and well-written with a thoughtful plan on how to improve our faulty healthcare system.

AMAZON VINE REVIEWS

Sleep-information Deprived 5.0 out of 5 stars

Call to action – based on solid information and analysis

October 14, 2019. Well written, this book is hard to read: it is tells compelling histories of health care gone wrong, analyzes root causes and is very well referenced. It authoritatively recounts the tortuous path of all of the important health care sectors* that have led us to fractured, inefficient, costly, wasteful and dangerous “health” care.

Magee’s book was also hard to read on a personal level: I am a retired physician – an infectious disease specialist in private practice in community hospitals for 26 years in Los Angeles and for 10 years was the chief medical officer for 2 community hospitals, one in LA and one in San Francisco. As chief medical officer, I oversaw quality improvement, risk management and medical staff governance. I look back on my career and my colleagues – we have been pawns and unwittingly manipulated.

Magee’s book powerfully shows how the work of countless principled, well-meaning, dedicated health care professionals over the ages has been impaired, stymied and continuously out maneuvered. The medical-industrial complex has taken advantage of and preyed upon these professionals, too often “guilting” them or taking advantage of their moral/ethical commitment to provide “care”.

This book is a call to action – a must read for every presidential candidate, senator, congressman, governor and legislator – and their staffs/advisors. These officials will be the ones who must pass effective legislation for the benefit of all people. Magee’s last chapter offers basic steps to reform the MIC regarding medical education, research, publications and marketing. He cites 10 reasons to consolidate oversight to a single centralized authority. This is all good foundationally, but the politicians with principled, knowledgeable health care experts must structurally re-build our health care system not just to fight disease, but to improve health and well-being.

M. Donnelly 5.0 out of 5 stars

A must read for all Americans!

August 22, 2019Fo. Reading Code Blue by Dr. Mike Magee felt like I was taking a graduate school class in the history of modern medicine while also being gifted a behind the scenes pass at what is really happening in the pharmaceutical industry and its ties to politics, lobbyists and the Medical Industrial Complex that seems to be benefitting everyone except us as patients.

This is a must read book for all Americans who want to understand how we became a nation with one of the worst healthcare systems and one of the sickest nations.

Take note current and future leaders on both a state and national level- Dr. Mike Magee gives you the play by play for how to fix this mess.

It is not too late to become the United States all people deserve us to be.

Greg Robertson 5.0 out of 5 stars

Mike Magee’s Code Blue ranks up with House of God. A must read for all. September 17, 2019

Having been a sales rep (Detail Man) for 30 years, I have seen it all. However, Code Blue opened my eyes to how I was played by the Companies I represented. I am too young for Medicare but too ” Old” to carry a bag anymore so I pay my own Healthcare coverage. Obamacare had been in the works long before President Obama was even born. The middle class was caught flat footed when it passed, thus making ends meet meant no more expensive vacations or new cars every other year. I didn’t realize how the Medical Industrial Complex wielded so much political power to keep American’s healthcare in the private sector. Dr. Magee’s well referenced book (I did go down many rabbit holes in the footnotes to see how his point was derived) is easy to read. He lays it out, where we came from, how we got here, and how to make it better. Greed however is the main topic or should I say “elephant in the room.” Code Blue in the hospital setting is a call to action….and that’s what we as consumers of healthcare need to do with Dr. Magee’s message. Spread the word!

Amazon Customer 5.0 out of 5 stars

Why we have our health care system.

November 14, 2019

Awesome book detailing how we got to where we are in health care. Japan and Germany are rated the best in health care. Didn’t realize that was after Marshall Plan helped them formulate national health care. Our vanquished enemies. Plan was to be same in US but never passed those who had profit motive foremost I. Health. Informative and at same time disturbing. Read it and think!

Amazon Customer 5.0 out of 5 stars

Not too surprised ?

July 4, 2019

Need to read slowly! As a retired nurse this is very good for information about the pharmaceutical industry!

Ryan 5.0 out of 5 stars

Required reading for anyone who works in healthcare

June 19, 2019

Great read and eye opening. Cuts through the slogans and calls out what the profit driven entities are actually doing2 people found this helpful

Kindle Customer 5.0 out of 5 stars

Great Book

July 22, 2019

Really great book that explains the ins and outs of how the medical industry came to be. I think it should be a must read for anyone living in the United States.

Katherine Y VINE VOICE 5.0 out of 5 stars

An Expert’s Take on the Current Healthcare Crisis

March 15, 2019

Mike Magee has taken the lightning rod issue of healthcare reform in this country and examined the problems created by what he terms the Medical Industrial Complex (MIC). He describes the enmeshed relationships that exist among, hospitals, insurance companies, and pharmaceutical companies. Added to that are the intertwined interests of academic institutions, advocacy groups, and the American Medical Association (AMA) which have all served to create a nightmare for regulators and sent healthcare costs soaring.

Dr. Magee is in a prime position to provide an overall review of the subject as he has been a practicing urologist, a senior executive in a major hospital system, an academician in medical schools, and the head of global affairs for Pfizer pharmaceuticals. What he has done in this manifesto is to reveal how we arrived at where we are today, how and why these afore-mentioned institutions became entangled. The book is a part history lesson, part expose and part proposal of the direction forward.

The history of the various medical entities such as the AMA, National Institute of Health (NIH), FDA, Medicare, HMOs, Pharmacy Benefit Managers (PBMs) and Centralized Research Organizations (CROs) is presented along with how these players have impacted healthcare. This may sound like dry reading. It isn’t. To illustrate how our current system has evolved, Magee describes some of the medical tragedies that have affected the development of the current regulatory system. He covers:

• the Massengill tragedy in 1937 where children died after being given a liquid version of sulfanilamide (an antibiotic) used to treat strep throat. The liquid version contained a chemical used in brake fluid.

• the use of the sedative thalidomide. Children exposed to the drug in utero developed deformities.

• the Tuskegee experiment that exposed African-American veterans to syphilis without their knowledge and left them untreated.

• the promotion of cigarettes to doctors by tobacco companies in the 1950s for physician use as a stress reliever.

• the promotion of the ADHD diagnosis in children, an example of drug companies creating a market for a product.

• the slow reaction of the MIC to the AIDS epidemic.

• the Nigerian tragedy where children diagnosed with meningitis were treated with a powerful antibiotic causing deaths as many of the children were too underweight and immunocompromised to withstand treatment.

• the opioid crisis as an outcome of pharmaceutical company promotion of an addictive drug.

In the final pages, Magee lists proposals which should be taken seriously by people no matter what their political affiliation. The work is well-written, understandable and offers an expert’s opinion on what is needed to resolve the health care mess we’re in. The book will probably anger some. You don’t have to agree with the general solutions he presents to benefit from his insight and knowledge. This is a must-read book for those wanting to educate themselves on the issue.

Miss Barbara TOP 100 REVIEWER VINE VOICE

5.0 out of 5 stars Arm yourself with the truth

March 17, 2019 Code Blue should be required reading for all, not just those who are concerned with the soaring cost of health care in this country along with the epidemic of unhealthy people who depend on it. Author Mike Magee, MD has creds. He was once on the short list to become Surgeon General of the US. Almost the first big blockbuster point he makes in this book is that the Health Care Lobby operates on 4x the funding as the Defense Lobby. Let that sink in.

Another interesting factoid (though not in itself incriminating) is that the symbol of the public health service is the Caduceus, twisted snakes wrapped around a rod is also the patron symbol for liars and thieves. How Freudian. Code Blue follows the blurred lines between physicians, hospitals, drug companies, researchers and the political influence of all. As the book progresses Magee tosses in government regulations, insurance companies, aggressive marketing, expansion oriented hospital chains, tobacco companies, religious zealots, and non-profit advocacy groups that all have their hand in the problem. The bottom line is that to stay alive the patient must pay the price.

Mcgee addresses the horrible situations that we’ve all seen on the news like the deplorable conditions found in the drug compounding centers that caused meningitis and the deaths of 64 people. We learn that the FDA tries of oversee an unfathomable array of commodities. From food safety, sperm donations, tobacco products, dietary supplements, prescriptions, OTC drugs, vaccines, biopharmaceuticals, blood transfusions, medical devices, electromagnetic-radiation devices, cosmetics and animal feed are all under their purview. The FDA oversees a trillion dollars in consumer spending on a rather small budget in comparison and with the big guns working against them.

The Medical Industrial Complex in the words of Yale Law School professor, Daniel Markovits, have turned America’s meritocracy into a “modern day aristocracy”. And we’re just getting started. This book, though complex, is written for the lay reader. If you’re like me it arms you with good information that you can go to your senators and congressmen with demanding a better use of your tax dollars. As I said at the beginning – this is a Must Read.

Robert D. Harmon 5.0 out of 5 stars

the medical industrial tapeworm

March 24, 2019

A detailed, and damning, look at what Dr. Magee calls the Medical-Industrial Complex, the manufacturing, marketing and lobbying groups that, through the 20th Century and into the 21st, made American medicine into the expensive monster that it is today, albeit delivering lower life expectancy than much of the developed world. We learn, indeed, that it is a drag on American prosperity, “the tapeworm of American economic competitiveness” with its expenses and cost-ineffectivity.

There’s more, however, and Dr. Magee shows us some of the more egregious examples: the early trend of aggressive marketing by pharmaceutical companies, who deployed legions of salesmen to doctors’ offices with incentives and free samples when the drugs’ damaging (or sometimes lethal) side-effects were not fully known, as well as more marketing by groups like the AMA against government efforts like national health care in Truman’s day, and against Medicare a generation later. We see the culture of “big ticket research and development” instead of a combined health plan, and the institutional distortions at agencies like the National Institutes of Health. We see the use of medical research as a screen for the tobacco industry.

The book, more and more, focuses on abuses in pharmaceuticals, since medicine is often pill-driven. The appearance of ADHD as a known syndrome would prompt hyping of drugs such as benzedrine, and, later, Ritalin and Adderall as over-used, and profitable, cure-all nostrums.

The book is especially timely now (spring 2019) with a major new lawsuit against Purdue Pharmaceuticals and the Sackler family. Dr. Magee shows how much industry lobbying and hype overall had contributed to the opioid epidemic, one that would leave a trail of addiction and thousands of deaths. Dr. Magee also talks about the offshoring of unproven or untested therapies and drugs in Third-world countries like Nigeria, a situation hinted at in the book and film “The Constant Gardener.” He also tells of the promotional and institutional changes wrought by the Viagra marketing craze.

There’s more: the encroachment of “faith based” health policy, notably during the HIV/AIDS epidemic and a convenient alliance between AIDS activists and pharmaceuticals to rush drug treatments. We see more religious opposition in fields like stem cell research.

Finally, we learn of some surprising alliances between advocacy groups and the industry, first in pushing Medicare Part D, and later, Obamacare.

It’s a sordid, infuriating and illuminating work by a physician who had worked in hospital administration, and then in a senior position at Pfizer. And it’s timely. Highest recommendation.

George J. Vendura Jr., Ph.D. 5.0 out 5 stars Powerful…Mesmerizing…Relevant…Encyclopedic.

June 4, 2019

CODE BLUE is exciting, a potential blockbuster. It strongly resembles “Silent Spring” by Rachel Carson which galvanized public opinion regarding gross abuses by the chemical industry that in turn motivated Washington into revolutionizing policy. In short, it changed the world. Some would say, it saved the world. But Carson’s book more or less came out the blue. With Mike Magee’s book the timing could not be better; the pump is already primed; the canon is ready to explode. With the issues of the Medical Industrial Complex and health care, the public and Congress are not nascent. They remain topics both current and of extraordinary interest that affect the health care – the lives – of 350 million Americans.

Magee’s writing style is gifted. Like Carson’s – no, better than Carson’s – I see it reaching high numbers of readers in three vital and distinct categories:
1. The ordinary public: The writing is clear and straightforward. It can be understood by the man on the street. It is intelligent with no hint of any dumbing down.
2. Medical and pharmaceutical industry professionals: These include insiders on both sides of the fence. The author’s style is sharp enough to engage the honest, well-meaning practitioners caught in the system. At the same time it is direct and biting enough to expose (and enrage) the abusers.
3. Legislators: I see this book also inspiring those in DC who ultimately have the power to impact public policy. One might argue that so far our representatives have not demonstrated sufficient gumption. From another point of view, I can see how CODE BLUE may very well provide the necessary motivation.

In short this is the book that the country needs.

Inna Tysoe

TOP 500 REVIEWER VINE VOICE

5.0 out of 5 stars

Timely and Engrossing

August 8, 2019 Mike Magee blows the whistle on the Medical Industrial Complex. He answers questions that we may not have thought to ask.

How did pharma know exactly which doctors to target so they would write prescriptions for opioids? Because the American Medical Association sold them the data. (A practice that continues to this day.) Or, as Mike puts it, “Every medical student in the United States is assigned a lifetime medical number at the onset of training. Whether an AMA member or not, each new physician’s identifying number becomes the property of the AMA. The AMA not only controls the Physician Masterfile database of 900,000 physicians but, for a healthy sum, licenses the information to a company that tracks physicians’ prescription profiling, “unless an individual physician contacts the AMA and specifically opts out.” The company then sells that information to every drug company in the US. Sales and royalties for proprietary data of this sort accounts for nearly 50% of AMA’s revenue.”

Why is it that virtually all hospitals that are deemed unsafe (as in you trip on wires unsafe) retain their JCAHO accreditation? And why was JCAHO so slow to respond to the opioid epidemic—mandating “Pain Management Standards (which encourage opioid use in 2016 if not later)? Because JCAHO’s is stacked by insiders all of whom have a stake in keeping this system as it is—even if it’s killing people. “Thirty-two members of the Joint Commission’s governing board are health systems executives. Among the remaining 12 members are representatives of the AMA and the American Hospital Association, as well as several health care lobbyists.”

And when the feds try to reform hospital billing an army of coders and billing experts fanned out across the nation, offering their services to hospitals for a fee. (They also offered their services to insurance companies of course.) So now hospitals have on board coders who tell doctors what codes to use and what procedures to run to make the stay as expensive as possible while insurers have coders on staff to look at patient chart and deny as much as possible. Meaning that “for there are now 16 health care workers for every physician in America, and why half of these workers have no clinical responsibilities.”

And he documents how in the 1990s when pharma did not have new drugs to sell, the Medical Industrial Complex came up with a great investment strategy: each other. Which is how the pharmacy benefit managers (or PBMs) came to be. PBMs are how the Medical Industrial Complex divides up the spoils.

And he sounds a warning. If we don’t fix our healthcare system, we will disintegrate just as the former Soviet Union did. The Soviet Union dedicated 22 percent of its economy to the military industrial complex and, when Reagan sped up the arms race, 27 percent. Their society came apart in exactly the same way ours is. Deaths of despair, declining birth rates, stagnation, decreasing life expectancy. All because one sector of the economy was getting all the money and human needs were being neglected.

On the other hand, we know (from a RAND study looking at our Marshall plan in which we funded the rebuilding of German and Japanese universal health care systems) that funding universal healthcare brings the nation together. And we would not have to start from scratch. We agree on the basics of what the healthcare system should cover, we spend a ton of money on it, we have an amazing number of educational institutions that train a growing healthcare workforce (whom we need to use better), we have a great research community, and we have all those non-clinical workers who really know they system. Imagine if, instead of playing games with one another, they were to work on helping people get the care they need?

And finally he gives us the two things that need to happen for us to reform our system. Let everyone buy into a public option, Medicare, or Medicaid and use international reference pricing of pharmaceuticals. In other words, pay an average of what ten comparator nations pay for drugs. That will bring healthcare costs down to earth and will deprive the PBMs of their reason to exist.

It’s a timely book well worth reading.One person found this helpful.

BooksRBrainFood 5.0 out of 5 stars

EveryBODY is affected by Healthcare because everyBODY dies!

August 7, 2019 This is such an important book looking at an insider’s view (from multiple perspectives) of the medical industrial complex. Some may complain or moan that Dr. Magee is selling the medical community or administrators out by telling this story but it needs to be publicly told. In this day and age, when our country, as wealthy as it is, has such awful statistics in the healthcare sector for easily preventable conditions, we need to know these facts. Washington, D.C. politics are too busy vying for power and not representing the needs of Americans when it comes to many issues, but healthcare is one that will universally affect each and every one of us.
Wake up people! Everyone dies! Therefore, preventing disease is important. Treating disease early is important. Having easy access to high quality care is important. Instead we are allowing decisions to be made by the MIC that will ultimately affect our ability to access these services (and for providers to provide them).
Thank you Dr. Mike Magee for this timely and comprehensive book outlining the background and conversation we need to be having in this country now about how we want our healthcare to be for the coming years and why it became the way that it is now.

Highly recommend!!
#

AnAmazonCustomerVINE VOICE

5.0 out of 5 stars

Should be mandatory readingMay 9, 2019. This book is exceptional. It should be mandatory reading for every clinician as well as politician. We all ready about the challenges and limitations of modern medicine, insurance and pharm with reform mentioned but never quite realized. However, the extent and severity is easy to underestimate until thrown into the midst of the beast. Our family experienced just such a trial by fire a few years back at which point my own understanding changed dramatically. This book sheds must needed light on a topic many people think they understand but probably still underestimate. Yes, it’s a complex topic but the need to tackle these issues is greater now than ever. Well written, this book not only illuminates the severity of the crisis but the human cost at both the individual and social level.

Kindle CustomerVINE VOICE

5.0 out of 5 stars

I enjoyed this one.

March 26, 2019

Disclaimer: I’ve worked in the medical field in peripheral and trivial ways, and I haven’t had insurance most of my life, so I’ve read several of these books to see what people think. With that said, I enjoyed this one, and the author owns up to his previous participation in the “Medical Industrial Complex.” While I personally doubt that anything significant will be done with the mess, and certainly not in my lifetime (I’m 53), I’m still always curious. I couldn’t find the page again, and I don’t have an index because I have an ARC (an advanced copy of a book), but the anecdote about the woman whose leg had been crushed and who didn’t want to go to the hospital would be me. No, they’re not supposed to turn people away, but that doesn’t mean the hospital can’t be in my house the next week. SO…I’m going off to read this one again.

Butcher

2.0 out of 5 starsLost me in the (personal history) detailsNovember 6, 2019I am normally a 5 star reviewer when it comes to expose’ books on things that affect the public welfare, especially those that pull the veil off of greedy or shady types that couldn’t care less what their actions do to others. This book started off well, but the author seemed a bit anal in his reporting, in that, he lost me in the extremely minute details of nearly every person or side story in the book. I was to the point of screaming, “Get on with it!” at times, when I practically became bored with the unnecessary minutiae of each and every new person introduced. I look for helpful information on the subject, not the career path or list of awards and many business/ health field connections of all the secondary players.
I was really happy to find this book, especially after reading all the great reviews, and wanted to pass it along to my daughter, a nurse by trade, but I lost interest about half way through. One too many rabbit trails or unnecessary ‘factotums’ about people I would never remember and had small roles in the big picture of the story. I almost felt as if the writer felt he had to lengthen the text with fluff information, or maybe he was a detail freak and owed it to each of these people and organizations an in-depth story on all of them. Maybe I’ll finish the book someday, but I was hoping for more information on the subject, and a lot less on backgrounds. Such as in the book “White Coats And Black Hats” or “Disconnect”, to name a few. He lost me in the details. Could have been a good read, in half the pages, without all the filler.

Becky Brooks

TOP 500 REVIEWER VINE VOICE

5.0 out of 5 starsCode Blue –

Should Be Required Reading For All Americans – Excellent!

July 12, 2019. First of all – this is a landmark book and should be required reading for all Americans on a topic they probably think they understand but really do not. Forget what you think you know about why healthcare, insurance, and drugs cost as much as they do. This book tells the tale in easily digestible detail, providing the historical and ongoing perspective to illustrate how things evolved to the unacceptable place they are today.

I have read several books concerning the state of health care in the US and other countries and none of them has covered the subject so objectively and factually.This is probably due to the fact that the author was/is a healthcare professional, a doctor who has also worked for big pharma. Not technically a whistle-blower he does present the facts about modern health care and has come to the conclusion that is there is a better way.

Eisenhower famously said after the conclusion of World War II, “ beware the military- industrial complex”, and rightfully so.This concentration of corporations, government, partisan politics, profits, and lobbying all acting together has essentially shaped a lot of the modern US today. He makes the correct point that now we have to deal with this same type of concentration the “ Medical Industrial Complex”.Big Pharma, insurance companies, doctors, all acting in their best interests: profits and cutting costs rather than cures and patient welfare. They have changed the whole approach to healthcare and so much privatization has not lowered costs nor improved preventative care or cures.

It is ironic that countries like Germany and Japan have all -exclusive, low cost, quality healthcare because after the war when we were rebuilding these countries under the Marshall Plan, we realized the social structure had to be built back up as well as the bombed buildings. We put universal type health care in place which still thrives today.

I hope this review piques your interest to read this book – there are many facts ( how the AMA came about, politics and back room deals to move things forward) that are eye-opening. Undeniable facts. The Medical Complex has become so big and powerful it is extremely difficult to change things – but as the author state we must. Life, liberty , and the pursuit of happiness certainly must not exclude the right to affordable and accessible healthcare. Access to healthcare is not a privilege.

Think of this book as a wake up call, much like Rachel Carson’s “Silent Spring” warned of the unpublished dangers of pesticides. It’s that big of a subject, that big of a problem, and that important a book.

Thanks for reading my review

Lehigh History Student

VINE VOICE 5.0 out of 5 stars

Strong analysis of where we are as a country with health care

June 26, 2019

Code Blue by Dr. Mike Magee takes a look at the idea of a Medical Industrial Complex akin to the Military Industrial Complex that President Eisenhower warned of. This complex is made up of Hosptials, insurers, pharmacists, professional medical organizations, and government entities including but not limited to the FDA, NIH and members of congress. This group has shaped and destroyed American health care by putting profits ahead of practice, disease research ahead of managed health and a pursuit that has led to sub optimal outcomes in health care. While it is clear that Mike Magee believes a single payer is the only way out he lays out his reasoning carefully and soundly. While I would like to believe there is a more free market way out that puts the labor market back on the onus of providing employer based health insurance as we proliferate right to work states that seems to be less and less likely. The author hear knows his topic well having been a physician, worked for Pfizer and then as a policy analyst writing on the topic of health care in America.
This book is well researched and for those who want an informed opinion of how we got to where we are this is a very good place to start. With my own background in health and pharma economics I found this a fascinating read and largely jived wit he macro data I have studied on health care trends. In short for 300 pages the author covers a tremendous amount of ground accurately and succinctly with thoughtful analysis that bears closer study.

Mike Grambo 5.0 out of 5 stars

“Code Blue” is an Insider’s Tale, and a Powerful One

July 30, 2019. Most important about “Code Blue; Inside America’s Medical Industrial Complex” is that it is written by a highly-placed pharmaceutical executive who could no longer ignore the destructive effects of the Medical Industrial Complex (MIC), and his own contribution to it. The strength of Dr. Magee’s book stems from his insider status which gives readers a unique perspective into how and why our nation’s healthcare system has become corrupted. His 412-page text is a damming indictment of healthcare entrepreneurs who have abandoned the public’s health and instead devoted their energies to profits and power.

Clearly, Magee’s position as an industry insider turned critic should enhance his credibility and help him influence his former colleagues within the MIC, along with the believers who already fear the MIC. A good example of how effective the converted critic can be is Nixon White House attorney John Dean who found new celebrity and authority with his change of heart. And certainly the best know example is the Biblical epiphany of Saul of Tarsus, a first-century Roman who persecuted early Christians but suddenly was redeemed after the image of Jesus knocked him off his horse, on the road to Damascus.

Military Industrial Complex
President Dwight Eisenhower famously warned in 1961 about the powerful influence of the Military Industrial Complex where defense contractors, the military and federal legislators worked to elevate and preserve their mutual interests, above the protection of the citizens they were charged to serve. In a similar fashion the “Medical Industrial Complex” works to further its own ends and is not tied to any higher purpose such as the health of country.

Magee goes to great length to show the interconnections between the many businesses, patient advocate organizations and the federal agencies that together form the MIC. The origin of the term “Medical Industrial Complex” is credited to the editor of the New England Journal of Medicine in 1980, but it is Magee who thoroughly demonstrates the complex’s power and methods. And to do that he summons interesting details about a number of key actors whose roles may be little known outside of top executive medical management; i.e., Magee’s circle. For example, socialites Mary Lasker and Florence Mahoney are profiled. Their patient advocacy steered the early development of the National Institutes of Health and its accompanying institutes. Their legacy is a distorted patient advocacy model, enabled by government funding of disease research that is an essentially corrupting component of the MIC.

Focus on Pfizer
Magee’s longest chapter, titled “Masters of Manipulation,” reviews the work of pharmaceutical companies to create diseases to be treated, usually by a drug that has already been identified but lacks a large, profitable patient base. Arthur Sackler and many others described in this chapter are the masters of manipulation. Like the tobacco companies’ criminal efforts to hide the harmful effects of nicotine decades earlier, many of big pharma’s ADHD drugs and pain relievers relied upon deception of the public and regulators for their success.

Throughout the book, we learn of Pfizer’s corrosive role within the MIC, courtesy of Magee’s senior position within the company. The index for this book carries more entries for “Pfizer” than any other topic.

An eye-opening appendix titled “Time Line of Pfizer’s Penalties and Transgressions,” enumerates 45-ethical misdeeds and financial penalties between the 1950’s and 2016. Thirty-one of these incidents involve fines, with eight worth more than $100 million each. The largest paid by Pfizer occurred in 2009 where the fine was $2.3 billion for illegal marketing activities involving the pain drug Bextra. Forty-four footnotes document the transgressions list. While these are Pfizer’s sins, Magee insists that every major drug and device company can produce a similar list. The listing of Pfizer transgressions is credited to the Corporate Research Project, a non-profit dedicated to corporate accountability. The “rap-sheets” for 11 other healthcare organizations are posted by this source.

Ample space (22 pages) is also given to Viagra in the chapter “Everything that Rises Must Converge.” In this chapter we learn about Magee’s role at Pfizer as chief clinician for Viagra which included managing the company’s use of retired U.S. Senator Bob Dole who appeared at live events and on television discussing erectile disfunction. Dole’s pitch was that it took courage to ask your doctor about Viagra.

Magee describes the extreme care Pfizer took to avoid the problem of Viagra being positioned as a lifestyle drug or Pfizer as a sex company through its newly launch Corporate Affairs office to coordinate Viagra’s promotion. At one point, Pfizer even got a Vatican representative to agree that Viagra promoted marital harmony. Corporate Affairs, through its engagement with governments and medical associations, assured the drug would be taken seriously. This chapter’s title reference to rising and converging describes Pfizer’s converging of its management efforts for Viagra inside its Corporate Affairs office.

Magee’s Epiphany
When did Magee’s epiphany occur—the change of mind and heart—that turned him from being a participant in the MIC to a powerful critic? At the close of the book he says that it took nearly 10 years of reflection and research—after leaving Pfizer—for him see the destruction that he enabled. There’s no doubting Magee’s sincerity and he pulls no punches in calling out his former employer for its behavior. But what triggered Magee’s profound, slow-motion epiphany? He doesn’t say specifically, but the plight of children harmed by medication seems to be the trigger (see paragraph below on children). In the chapter describing the creation of the Attention Deficit Hyperactivity Disorder (ADHD) Magee says:
“But I never anticipated how far the masters of manipulation would be willing to go in pursuit of profit and/or professional prestige until I witnessed Sackler’s devotees place a large portion of our very young children on psychotropic drugs for reasons that are not all clear.”

And so it may be the report in 2015 by a CDC epidemiologist that confirmed for Magee that it was time to speak out. The report estimates that ten-thousand infants in the US, aged 2-3 years, are already receiving medication for ADHD.

Or more certainly, Magee’s change of heart came after Pfizer published its “Statement of Defense” in July 2007, regarding Pfizer’s Nigerian clinical trial involving antibiotic Trovan which was administered to children. Pfizer argues that Nigeria had no law requiring an ethics review before starting clinical trials. About 12 children died as a result of the clinical trial, many more were injured. Magee resigned from Pfizer two months later.

Root Cause of the Problem
What is the root cause of our Code Blue condition? It is greed, allowed by our entrepreneurial-focused healthcare system, says Magee. Greed is often accompanied by corruption and ethically disreputable behavior. At worst greed results in illegal activities, and sometimes even the death of patients.

Equally complicit—or perhaps more fundamental than greed– is our society’s long-standing distrust of government regulation of business. Magee points out the irony that Americans distrust “Big Government” yet are willing to accept the inequities and greed of “Big Business.” Red baiting has been used effectively for nearly 100 years to discredit any reform as anti-American and communistic if it threatens the financial life of powerful organizations like the American Medical Association.

Deaths of Children
But even if greed is the root cause, Magee hints at the antidote. Interestingly, it is children who can shame the country into compassionate, responsible action. Throughout the 20th century our entrepreneurial society suppressed government “interference” in medicine, with only a few exceptions As evidence of how difficult it is for our legislators to take any action restricting the MIC, Magee cites four instances of pharmaceutical company malfeasance that actually got legislators’ attention, but it took the death of children to result in legislation. Without these disasters the regulation of drugs would be far less restrictive.

Legislation Resulting from Deaths of Children
Date–Substance—Law
*1902—Diphtheria antitoxin derived from horses and administered to children.
Biologics Control Act of 1902.

*1938—Sulfanilamide elixir given to children for strep throat.
Food, Drug and Cosmetic Act of 1938.

*1962—Morning sickness drug Thalidomide causes severe birth defects.
Drug Amendments of 1962.

*1997—Antibiotic Trovan given to children in a hurried, illegal clinical trial in Nigeria.
Medicare Modernization Act of 1997 (required registration of clinical trials).

How to Fix the Problem
Magee’s prescription for healing the nation’s healthcare system is lengthy. He identifies 25 steps spread over four domains; medical education, clinical research, publications and marketing, all corrupted by the greed of the MIC, especially by the drug companies.

But incremental change isn’t likely to work, says Magee, and a single payer system that recognizes each individual’s right to healthcare as “common decency and common sense” is necessary. And with that recognition a cascade of changes will be unleashed that will tackle his 25 steps for repairing our nation’s healthcare.

Fortunately, distrust of the MIC is growing, reports Magee, and arguments from the MIC about stifling innovation through “un-American” regulations no longer carry weight. Instead, public opinion now favors Medicare for all, or at least some kind of single payer oversight and multi plan access over our existing options.

Formatting Issues
Heavily footnoted manuscripts like “Code Blue” present a problem for publishers—and ultimately the reader—regarding where to put footnotes. The choices are:
1) At the bottom of pages (ideal, as found in law journals, but most difficult for publishers),
2) At the end of chapters (moderately helpful), or
3) At the end of the book, grouped by chapter (least helpful, but easiest for book print layout).

Unfortunately, this last option is employed for the hundreds of cited sources found in the 15 chapters of “Code Blue.” Simply, this format makes it difficult to get the most out of an author’s efforts to document and further explain the text.

While many of the footnotes include web addresses, these are often very long and must be typed exactly to connect with the source document, if it still exists at the web source. A better approach is to provide readers with an online listing of sources where web addresses can be hyperlinked to the source document.

Another formatting issue with “Code Blue” is that the title of individual chapters are not reprinted at the top of either the left or right-hand pages, as is common in non-fiction texts. Printing the chapter titles underscores for the reader the basic theme of the chapter. And if you are reading the footnotes with any frequency, the chapter titles help readers to return to the text at the appropriate point.

La Vida Loca

VINE VOICE 5.0 out of 5 stars

Eye opening! August 28, 2019

Oh my goodness, this book is shocking revelation and everyone should read it. In short, how Politics and Healthcare share the bed making the babies named Profits. This book made me angry and disappointed. While I already knew that US healthcare is not ideal I had no idea how bad it is. In my defense we are healthy family and don’t even see doctors.. The book kept me interested for the entire time and made me raise my eyebrows for half the time. I can’t wait for my husband to read it too so we can dive in discussion! Information given in this book is definitely a conversation starter too!One person found this helpful

Shelly9677

5.0 out of 5 stars

Everything you should know about the Medical Industrial Complex in one riveting book!

June 15, 2019. Everything you should know about the Medical Industrial Complex in the United States in one riveting book! As a physician, former hospital administrator and former pharmaceutical executive, author Mike Magee takes us into the corporate world of one of the most complicated and costly industries in the US. This book dives into the history, context, back story, key players, legislation, competition and collusion that have shaped the nation’s present-day health care industry. Although there is quite a lot of content, this is anything but a dry read. It is insightful and thought-provoking.

CCE VINE VOICE 5.0 out of 5 stars

Well done!

April 28, 2019. This is a really well done exposé on the current medical industry issues… and highlights the need for healthcare reform. Magee has been on all sides of the industry and it’s a bit shocking how symbiotic the industry has become. Money, money, money. This book is not just an academic paper though – it’s a character centered narrative. You’ll learn more about the industry than you want to know!

FiFi’s Mom TOP 1000 REVIEWER VINE VOICE

4.0 out of 5 stars

Read it and weep—we need to “reshape the future”

March 8, 2019. “How have we managed to have a healthcare system that delivers such poor results at double the cost of any other developed country?”
This soon to be published and well researched book, works on delivering those answers.
This is a book that draws back the curtain and causes us to look at this giant industry that needs fixing NOW.
Don’t miss this timely read.
Highly recommended

Worddancer Redux VINE VOICE

5.0 out of 5 stars

Powerful and accessible

April 21, 2019.

There isn’t a lot in this book that was a revelation to me. But that’s not what I was looking for. I teach material about pharm testing and marketing, and FDA regulations. My students read and like some of Goldacre’s work/screeds. CODE BLUE will be a good addition to their reading.

David 5.0 out of 5 stars

Authors take on billing/coding???

November 27, 2019. He mentions in his section for billing coding the difference ICD-9 CM 428 Heart failure versus 428.21 Systolic Heart Failure, Acute.
1. Why is the author referencing in his billing/coding section ICD-9 when this code set expired 09/30/15? If he is going to provide information regarding diagnosis coding he could of simply identified 428 was not even a valid billable code in ICD-9 CM and that the Heart Failure NOS was 428.9 prior to 10/01/15. And if he is going to discuss coding, he should of cross-walked heart failure to ICD-10 CM I50.9 Heart Failure, unspecified and I50.21 Acute systolic (congestive) heart failure.
2. Then to describe how there is a difference that heart failure unspecified and acute heart failure can effect in difference of reimbursement that should be not be considered a big revelation that an inpatient with managed heart failure as secondary condition is not going effect the severity of the DRG assisgnment compared to a patient with acute heart failure.
3. To state that an ER doctor that treats a fracture is paid different than a provider who treats a fracture then writes a pain medicine prescription could result in a different level of reimbursement and throwing the problem with opioid use disorder does not accurately explain to the reader who is not familiar with coding that prescription drug management is moderate risk for evaluation and management coding and could effect reimbursement.
4. To describe the difference in reimbursement for CPT 99213 and a level 4, not reference what reimbursement he is referencing that pays those rates, And failure to mention the upcoming changes the AMA is going to do in 2021 to coding of visits and how CMS was going to pay all visit level 2-4 at one rate before the AMA step in makes me feel he should tone it done on the negativity in the coding and billing section.

M. Tanenbaum VINE VOICE 5.0 out of 5 stars

An up-to-date critique of our failing medical system in the US

September 5, 2019. Do you wonder why our medical system is so screwed up? How did it happen and how can we fix it? Dr. Magee, a medical historian and journalist, formerly a senior executive at Pennsylvania Hospital as well as head of global medical affairs for Pfizer, provides a depressing but expertly written viewpoint of how the pharmaceutical industry, the politicians, and the medical industrial complex evolved to benefit shareholders more than patients. Highly recommended.

LifePathin4D

4.0 out of 5 stars

Recommended Read October 14, 2019

This is an informative look at the healthcare system in the United States by someone who is well -informed and knowledgeable about the subject. Our Healthcare system is in need of a major overhaul and this book addresses many key points that people should be aware of as citizens. No matter what your views on our current medical system you should read this book to remain aware and informed. This is a very well written book that is easy to read.

Demi Gentry VINE VOICE

5.0 out of 5 stars

Great Read

November 22, 2019. As working in the medical industry and raised my a surgical nurse, I found this book to be a very informative read. Looking at the health care system in the U.S. compared to other countries is confusing and infuriating, and this book gives insight and details on why that is.

Mike Oweda VINE VOICE

4.0 out of 5 stars

Code Blue By: Mike Magee

August 4, 2019

“Code Blue” is the phrase customarily announced over hospital public address systems to alert staff to an urgent medical emergency requiring immediate attention. This book was really good and kept my attention throughout.

Texas shopper 1.0 out of 5 starsHard to follow the author’s arguments.

July 18, 2019Format: HardcoverThe author jumps all over the place chronologically in presenting his facts. He is very difficult to follow. Should have lined up his material in order before he began writing this book. Very disorganized.

NETGALLEY:

 Holly C, Reviewer    

This is such an important book looking at an insider’s view (from multiple perspectives) of the medical industrial complex. Some may complain or moan that Dr. Magee is selling the medical community or administrators out by telling this story but it needs to be publicly told. In this day and age, when our country, as wealthy as it is, has such awful statistics in the healthcare sector for easily preventable conditions, we need to know these facts. Washington, D.C. politics are too busy vying for power and not representing the needs of Americans when it comes to many issues, but healthcare is one that will universally affect each and every one of us. Wake up people! Everyone dies! Therefore, preventing disease is important. Treating disease early is important. Having easy access to high quality care is important. Instead we are allowing decisions to be made by the MIC that will ultimately affect our ability to access these services (and for providers to provide them). Thank you Dr. Mike Magee for this timely and comprehensive book outlining the background and conversation we need to be having in this country now about how we want our healthcare to be for the coming years and why it became the way that it is now. Highly recommend!! #CodeBlue #NetGalley
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 Linda S, Librarian    

For another look at America’s health care system and the problems with which it is associated, see CODE BLUE by Mike Magee. This non-fiction work unabashedly addresses “profit over health: the fascinating, infuriating story of how we built the world’s most expensive, least equitable health care system – and what we can do to fix it.” Magee, who is a medical doctor and historian on the faculty at the University of Hartford, has also worked for Pfizer and edits his own blog, HealthCommentary.org. His biases and frustrations are evident there as well as in CODE BLUE (a title selected to convey his sense that “the American health care system is in critical condition”) where he notes, “Americans spend from 50 percent to 100 percent more on health care as a share of GDP than people in other industrialized countries do, and for all our high expenditure we get collective outcomes that are demonstrably worse.” Clearly, this is an extremely complex topic, and one that will continue to be debated publicly, especially with respect to basic universal coverage proposals. Magee devotes roughly a fourth of this text to an appendix, notes and an index. He also includes several lists, including “Some Basic Steps to Reform the Medical Industrial Complex,” looking at education, clinical research, publications and marketing. Overall, his pressing sense of urgency seemed to negatively impact his objectivity even though CODE BLUE received a starred review from Kirkus.
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 noor i, Reviewer    

Anti-Pfizer diatribe by a former Pfizer employee. Also there isn’t really any objective, broad-based observation here. Didn’t like it. Half-baked. Thanks to the publisher for the ARC.
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 Erin G, Librarian    

An eye-opening, inside look at the broken state of American health care. Magee, formerly a physician-spokesperson for Pfizer, takes on everything from the American Medical Association to big pharmaceutical companies. You will feel better informed after reading this book, but much worse about our nation’s health care system, although Magee offers practical suggestions for how our political leaders, medical providers, and others can fix things.
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 Shelly H, Reviewer    

Everything you should know about the Medical Industrial Complex in the United States in one riveting book! As a physician, former hospital administrator and former pharmaceutical executive, author Mike Magee takes us into the corporate world of one of the most complicated and costly industries in the US. This book dives into the history, context, back story, key players, legislation, competition and collusion that have shaped the nation’s present-day health care industry. Although there is quite a lot of content, this is anything but a dry read. It is insightful and thought-provoking.
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 Sandra H, Librarian    

This is a very well written book. It provides an overview of what the author calls the medical industrial complex. He tells the history of the medical industry up to the present day. Very readable and enlightening.
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 Donna H, Reviewer    

One of the most extensive yet interesting books I’ve read to date on this subject matter. Mike Magee opens up about the greed, the collusion, the profitability factors, the fleecing of America in the name of dollars and cents. Personally this hits home as I suffer from a variety of ailments requiring medical treatment on a regular basis and have seen the attempts to get America hooked on drugs. For example I’ll show two of the most recent: 1. Pertained to childbirth pain from a high risk section in which I was offered repeatedly oxycontin like candy. You know the famous nurse’s line: Just press the button if you need it! 2. When I was younger ADHD was not the phenomenon money maker it’s now. It was often treated with medicine such as Ritalin but it was glamorized like today. Now if you can’t sit still it’s offered without hesitation. Thankfully my mother declined not knowing the risks and I’m forever grateful she did. I have always been hyperactive with that constant need to keep moving at all times. I function fine and can’t imagine what these god awful drugs are doing to our children. In fact I graduated with top honors, inducted into national criminal justice societies, and graduated with MPA/CJ degree with Points of Light Award from Pres. George HW Bush in 16 all with ADHD. Folks today want a quick fix and will do anything for it. Buyer beware especially with regards to meds as you honestly don’t know the reasoning behind the fleecing until deaths occur. Sadly we now have an epidemic with opiods and pain killers among others such as Viagra and it’s all for profit. It’s sad that America has become the guinea pig for corporate and or individual greed. Please do yourself a favor and read this book in its entirety. As a mother of a son born with Vater Syndrome who went code blue and who knows every hospital code over the years of his extensive treatment I urge everyone to get a copy and crack this open. You won’t regret you did! The best way to stop the problem is to educate oneself as ignorance is not an excuse. Protect yourself, know your body, know your limits. Thank you to Mike, the publisher, NetGalley, and Aldiko for this ARC in exchange for this honest review. A real eye opener in more ways than one!

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