Harriet A. Washington has serious objections to corporations' place in the American health care system. In Medical Apartheid (which won a National Book Critics Circle Award), she traced the abuse African-Americans have suffered at the hands of researchers through history. Deadly Monopolies continues to examine the myriad ways in which the system falls short for many. It is alarming and thought-provoking--and, starting from the title itself, explicit in its thesis.
Washington makes the case that an array of factors--elements of patent law, lucrative partnerships between universities and pharmaceutical companies, and so on--are driving up costs, limiting access to care and stifling innovation. She doesn't limit herself to the U.S., either, reporting extensively on sketchy medical trials conducted abroad and the difficulty of securing pricey drugs in the developing world. The economics of the pharmaceutical business are such that developing a medication to treat unwanted facial hair takes precedence over curing sleeping sickness.
Deadly Monopolies could have been a polemic, long on tirades and short on evidence, but Washington is thorough, diving into the details of specific lawsuits and clinical trials to make her case. There's room for debate about her conclusions--for example, pharmaceutical companies would likely argue they spend far more on R&D than Washington claims--but this is essential reading to educate yourself on these hot-button issues. --Kelly Faircloth, freelance writer