How to Make a Killing

How did a lifesaving medical breakthrough become a for-profit enterprise that threatens the people it’s meant to save?

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Six decades ago, researchers achieved the impossible: a treatment that made kidney failure a manageable condition instead of a death sentence. And yet, in the hands of a predatory medical industry, this triumph led to skyrocketing costs and worsening care.

A gripping microcosm of American health care gone wrong, How to Make a Killing recounts how the optimism of the 1950s and 1960s—when transplants and early dialysis machines offered hope—gave way to anguished debates about the ethics of rationing (and profiting from) life-saving care. After Congress made renal disease the only “Medicare for All” condition, Big Dialysis proliferated, and the Hippocratic oath gave way to the profit motive.

A triumph of investigative research, Tom Mueller’s book features an unforgettable cast of characters: CEOs who dress as Musketeers to exhort more aggressive profit-seeking, nephrologist insiders who reveal the substandard care this causes, and heroic patients who risk their lives to reveal the truth.