Few would disagree that the health care system in this country is breaking down. If you are one of the 45 million without health insurance you already know how difficult it is to get health care, and if you have medical insurance you continue to watch as your insurance premiums and deductibles go up year after year. Medicine has become more about money and less about patient care. We are told we spend more because we have the best health care system in the world.

But as Maggie Mahar points out in her new book, Money-Driven Medicine: The Real Reason Health Care Costs So Much, "We spend twice as much as Japan on health care -- yet few would argue that our health care system is twice as good." Mahar, a seasoned financial journalist, takes an in depth look at what she calls America's complicated and increasingly dysfunctional health care system, and what she finds is disturbing. Frankly, from a patient's perspective, it's reprehensible.

Doctors aren't allowed to function as doctors in putting a patient's needs first -- no -- medicine is business and corporations decide on a patient's treatment. To put it bluntly, medicine is a market-driven $2 trillion industry rife with competition. To cite just one example of what is taking place, and to illustrate how medicine truly sees itself  -- Milwaukee hospitals spent more in one year on advertising than fast food business did. Reviewers are calling Mahar's book a thoroughly researched and carefully reasoned study. I call it gutsy because she takes no prisoners and she isn't keeping any secrets. Until the day comes when doctors are allowed to practice medicine once again, with the priority on the patient and not corporate profit, the wheels on this buggy are going to keep falling off one by one until the axle completely splits in two. A must read for anyone who wants to understand how the system works and what motivates the players. The patients aren't even in the game. And that is what is truly appalling.