Short-listed as a finalist for the 2023 New York Public Library's Bernstein Book Award for Excellence in Journalism
How did a lifesaving medical breakthrough become a for-profit enterprise that threatens many of the people it’s meant to save?
Six decades ago, visionary doctors achieved the impossible: the humble kidney, acknowledged since ancient times to be as essential to life as the heart, became the first human organ to be successfully replaced with a machine. Yet huge dialysis corporations, ambitious doctor-entrepreneurs and Beltway lobbyists soon turned this medical miracle into an early experiment in for-profit medicine—and one of the nation’s worst healthcare catastrophes.
With powerful insight and on-the-ground reporting, New York Times best-selling author Tom Mueller introduces an unforgettable cast of characters. Heroic patients, including a Hollywood stuntman and body double, risk their lives to blow the whistle on how they’ve been mistreated. An unpaid activist living in a south Georgia trailer park fights to save patients from involuntary discharge from their lifesaving care. Industry insiders put their careers on the line to speak out about the endemic wrongs and pervasive inequality they’ve witnessed—and about dialysis executives who dress as musketeers and Star Wars characters to exhort their employees to more aggressive profit-seeking.
Mueller evokes the scientific ingenuity and optimism of the 1950s and 1960s, when the burgeoning field of organ transplant and early dialysis machines offered long-awaited hope for lifesaving care. That is, until a New York salesman had himself dialyzed on the floor of the House, and Congress made renal disease the only “Medicare for All” condition—opening the financial floodgates for Big Dialysis. Of the thousands caught in a web of corporate greed, a disproportionate number are Black and Latino, highlighting the stark racial divides already endemic to American medicine.
How to Make a Killing reveals dialysis as a microcosm of American medicine and poses a vital challenge: find a way to fix dialysis, and we’ll have a fighting chance of fixing our country’s dysfunctional healthcare system as a whole, restoring patients, not profits, as its true purpose.
Tom Mueller’s writing has appeared in The New Yorker, National Geographic, New York Times Magazine, and Atlantic. He is the author of the New York Times best-selling Extra Virginity about food fraud, and Crisis of Conscience on whistleblowers and their enemies.
New York Times best-selling author Tom Mueller very well could be rocking the foundations of many a corporate boardroom with this book.
— Dialysis Ethics
We have accepted too much for too long. There are those who will say that the book exaggerates and that things he reports don’t happen. Maybe they don’t in some/most clinics, but even if they happen in a few clinics, we can do better.
— Beth Witten - Home Dialysis Central
We urge you to stop what you’re doing, buy this book, and read it from cover to cover. The book presents nothing short of an indictment of rabid capitalism run amok, effectively turning what should be a life-saving branch of medicine into a criminal enterprise.
— Pam and Russ Martens - Wall Street on Parade
Tom Mueller goes deep, then wide, then straight for the jugular of the corporate predators who are getting rich by exploiting the poor and vulnerable. Anybody who can read How to Make a Killing without getting outraged must be unconscious. This book raised my blood pressure by at least thirty points.
— Carl Elliott, author of White Coat, Black Hat and Better Than Well
I loved Tom Mueller’s beautifully written and fascinating account of both the miraculous possibilities of medical technology and the perils of poorly structured markets. There is universal medical care in the United States, but only for kidney disease. How a program started by Richard Nixon and corrupted by finance has saved lives, and cost them, is the story of modern America.
— Matt Stoller, author of Goliath: The 100-Year War between Monopoly Power and Democracy?
Inspiring and deeply distressing. Mueller illustrates how modern medicine could devise technologies to literally revive people dying of kidney failure and how such miracles became perverted and incentivized abuses. A sad, shocking tale.
— Ezekiel J. Emanuel, author of Which Country Has the World's Best Healthcare?
Tom Mueller’s How to Make a Killing is a rich and sweeping saga that is, sadly, a quintessentially American story: How a miracle medical machine transformed into profit machine, sick and suffering patients be damned.
— Jesse Eisinger, author of The Chickenshit Club
A terrifying story of profit before patients, and chilling glimpse of what can happen when private companies are allowed to take charge of healthcare.
— Dr. Gavin Francis, author of Recovery