Drawing on a quarter-century's work, Fred I. Greenstein, one of our keenest observers of the modern presidency, provides a fascinating and instructive account of the qualities that have served well and poorly in the Oval Office from Franklin D. Roosevelt's first hundred days to the beginning of George W. Bush's presidency. Greenstein offers a series of bottom-line judgments on each of his twelve subjects and a bold new explanation of why presidents succeed or fail. Previous analysts have placed their bets on the president's political prowess or personal character. Yet by the first standard, LBJ should have been our greatest president, and by the second the nod would go to Jimmy Carter. Greenstein surveys each president's record in public communication, political skill, vision, cognitive style, and emotional intelligence--and argues that the last is the most important in predicting presidential success.
A meticulously reported expose uncovers exactly how the drug industry boosts sales and bilks consumers in the most lucrative prescription drug market in the world. As the pharmaceutical industry invests more and more in the development of new drugs, true breakthroughs are few and far between. Into the breach comes a panoply of product-line extensions and me-too drugs aimed at grabbing market share. The industry plows its high profits back into research, but invests an equal or greater sum in flogging its products in every imaginable venue. Research studies are designed to support marketing claims. Many doctors all over the country get their first information about new drugs from a salesperson. And, increasingly, prescription drugs are pitched to consumers on TV and the internet with images of hope, terror, or chic. Evidence-based practice guidelines, which endeavor to get the right medicines to those who will benefit most, can't be heard over the din. Having created an unprecedented number of "megabrands"--blockbuster drugs with huge sales--and undergone an extraordinary wave of consolidation, some drug companies now find themselves in a precarious position. Patents are expiring on flagship products. In order to sustain the growth Wall Street has come to expect, these companies must produce billions of dollars worth of new revenue--fast. But can Americans continue to bankroll Operation Grow Big Pharma? Must we swallow the bad with the good?
