Business Books

By Tiffany Sharples

The Healthcare Fix: Universal Insurance for All Americans

By Laurence Kotlikoff

MIT Press; 98 pages

When the first baby boomer filed for Social Security in mid-October, chills must have coursed along Laurence Kotlikoff's spine. For years the Boston University economist, among others, has been warning of our pending financial crisis--the burden of Social Security and health care for our largest generation on the shoulders of a diminishing proportion of workers. "We're creating our own fiscal catastrophe," Kotlikoff said in 2004. At the same time, businesses have been desperate to contain rising health-care premiums. Three years later, Kotlikoff is still determinedly on message--and offers his own radical cure for the problem.

With the earnest tone of a teacher aching for his students to understand, Kotlikoff creates a stark picture of our looming financial straits. The "fiscal gap," or difference between what social programs cost and the money the government is bringing in to pay for them, is now about $230,000 per citizen.

Kotlikoff's most interesting discussion is that there's no point debating the merits of socialized medicine, the one-payer system used in the U.K. It's already here, he says. It's just hugely inefficient, exemplified by many of the 47 million uninsured turning to emergency rooms for care. The other piece of it, Medicare and Medicaid, is going broke as the ratio of retirees to wage earners rises dramatically with the aging of 77 million baby boomers.

But we know that. In what feels like a breathless crescendo, he launches his health-care manifesto. He suggests eliminating Medicare and Medicaid and using those funds to provide health-insurance vouchers for all. In his model, the more precarious your health, the larger the voucher, which you could use to purchase plans from private insurance providers.

Kotlikoff acknowledges his detractors, who argue that his plan for a complete overhaul, although market-based, is politically nonviable. Unlike the plans in Massachusetts and California that are buttressed by existing programs, his wouldn't be the sort of incremental change Americans have come to expect.

Yet perhaps that is Kotlikoff's crucial point and one that our presidential candidates should bear in mind. If our health-care woes are reaching critical mass, perhaps drastic measures are the only way to effect real change.

Valley Boy: The Education of Tom Perkins

By Tom Perkins

Gotham Books; 289 pages

Self-effacing is rarely a term used to describe wildly successful venture capitalists. Yet in Tom Perkins' memoir, the Silicon Valley legend--hardly short of ego--manages that trick, revealing himself in all his "nerdy" glory and lifting the veil on the very good life. He sews dry humor through tales of yachting triumphs, road rallies in expensive cars, tech start-ups and the boardroom coup he instigated at Hewlett Packard. Looking back without rancor or remorse, he has a knack for storytelling that makes him feel like a buddy who never fails to laugh at himself.

Think Big and Kick Ass

By Donald Trump and Bill Zanker

Collins; 384 pages

With the grace of a Ginsu-knife salesman, Donald Trump mixes advice--"Go with your gut" and "When somebody screws you, screw them back in spades"--with self-aggrandizing outbursts, like declaring that his dealmaking is so superb he "could negotiate peace in the Middle East." He is echoed only somewhat less obnoxiously by his co-writer, Bill Zanker. Thankfully, Trump stops short of listing the powerful women he claims to have slept with. "If I did, this book would sell 10 million copies," he says, adding smugly, "maybe it will anyway." Unfortunately, he's probably right.