I just finished this book and found it not only relevant but imminently readable for healthcare professionals as well as for the public. It’s so easy in our unbalanced health care system to lose sight of our responsibilities to individual patients and our need to continue to make the system fair, caring, and accessible. I am a nursing professor and plan to give this as a gift to my nursing student graduates each year.

Bulger’s “Healing America: Hope, Mercy, Justice, and Autonomy in the American Healthcare System”, Prospecta Press, 2010. The subtitle of “Healing America” should be “A Call to Action”. The concepts of a compassionate, effective, equitable, and affordable healthcare system could not be more timely and important. These concepts have consumed the mind and attention of the author, Roger J. Bulger, since even before matriculation in medical school, and have been refined over the subsequent half century as he became a consummate physician, academician, and administrator. The concepts were intensely challenged and survived (as fortunately did the author) two bouts of near-lethal, systemic malignancy (lymphoma). Ideally all Americans (truly all people, and especially all healthcare professionals and all members of state and federal legislatures) should read this book. Bulger’s appreciation that healthcare is fundamentally a moral issue, and only secondarily an economic consideration, is a perspective necessary for our President, our Congress, our Governors and legislators as they design the healthcare system of the 21st Century. So too is Bulger’s insight that public health and the science and practice of clinical medicine are estranged, but must collaborate collegially if we are to have a system that promotes health as well as one that treats illness. The chapter on covenants and commitments should be required reading for all healthcare professionals. The values of organized healthcare systems (societal, university, professional, and business values including justice, hope, mercy, discovery, education, competence, and commitment) are foundational, and allow assessment of the performance of healthcare institutions and practices. The appendix provides a model of an organizational therapeutic index to assess institutions (such as academic medical centers), and should be adapted for each and every healthcare institution. Ronald B. Miller, M.D.

Roger J. Bulger, M.D., was the first Executive Officer of the Institute of Medicine (IOM) at the National Academy of Sciences. Later, he was chancellor of the University of Massachusetts Medical Center at Worcester, Massachusetts, and dean of its medical school; president of the University of Texas Health Science Center at Houston; and president and CEO of the Association of Academic Health Centers in Washington, D.C. He has led a rich life dedicated to serving others. I highly recommend his new book: Healing America: Hope, Mercy, Justice and Autonomy in American Health Care. Here is a brief excerpt: In the last chapter, Dr. Bulger writes, “I propose that our society should ultimately require our health care sector to provide mercy, justice, hope, and individual autonomy for all our citizens. In health care, mercy and justice may be expressed better by referring to compassion and equity. Most observers would surely agree that individual autonomy, equity, compassion, and hope are core American values. Whatever our society is doing and shall do in the future, we must measure our health care against these four basic values.” Dr. Bulger writes from his perspective as a physician, a patient, and a caring American. He illustrates his views by sharing his personal history (including three life-threatening events in 1940, 1994 and 2007) and his family history. He weaves into this a remarkable discussion of philosophy, ethics, religion, values, arts, suffering and compassion. His new book is a real treasure! Share this book with your friends and colleagues. You’ll be glad you did. Walter J. Unger, Unger & Associates: A Healthcare Advisory Group, Laguna Niguel, California.