Taming the Beloved Beast: How Medical Technology Costs Are Destroying our Health Care System , the latest book by Hastings Center scholar and co-founder Daniel Callahan, “takes on the tough political, cultural, and economic challenges to real reform,” writes James P. Scott in a recent Health Affairs review (January 2010). Scott, a family practitioner and dean of the PeaceHealth Advanced Training Program in clinical improvement in Portland, Oregon, calls the book “a provocative look at the cost crisis in U.S. health care.”

In the book, Callahan examines how technology drives health care costs, and challenges whether there is the political will to “bend the cost curve” required for a sustainable health care system. The review notes that Callahan’s solution is “the part of this book that will draw the most fire: Callahan’s call for explicit values and evidence-based limitations of care (rationing).” Scott writes that, while the 79-year-old Callahan’s “call for using age explicitly as a criterion for care decisions will be greeted with cries of ageism,” his “conclusions are inescapable.” 

Scott concludes, “What is unique is [Callahan’s] willingness to take evidence to its logical conclusions and highlight the tough cultural, political, and ethical dilemmas that confront us—sooner or later.”