Since the introduction of Medicare and Medicaid in 1965, the American health care system has steadily grown in size and complexity. Muriel R. Gillick takes readers on a narrative tour of American health care, incorporating the stories of older patients as they travel from the doctor’s office to the hospital to the skilled nursing facility, and examining the influence of forces as diverse as pharmaceutical corporations, device manufacturers, and health insurance companies on their experience. A scholar who has practiced medicine for over thirty years, Gillick offers readers an informed and straightforward view of health care from the ground up, revealing that many crucial medical decisions are based not on what is best for the patient but rather on outside forces, sometimes to the detriment of patient health and quality of life. Gillick suggests a broadly imagined patient-centered reform of the health care system with Medicare as the engine of change, a transformation that would be mediated through accountability, cost-effectiveness, and culture change. “With passion and skill, this book offers providers and consumers of health care a rare apolitical analysis of important aspects of the health-care system and how it might be improved.” — Library Journal “ Old and Sick in America is timely, highly original, and critically important. Everyone who goes to a doctor or hospital will want to know what is in this book.” — Sharon Kaufman, University of California, San Francisco Navigating the complexities of elder care in the United States Muriel R. Gillick, M.D., is a member of the Division of Aging at the Brigham and Women’s Hospital and professor of population medicine at Harvard Medical School.