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But, as Rosenthal points out, our American healthcare non-sys- tem can't even be considered the result of capitalist forces playing themselves out in the open market. On the contrary, it's all rigged, with huge corporations spending billions on lobbying and campaign contributions to ensure a legal, regulatory, and business environ- ment that always, always financially benefits them against the inter- ests of patients. Rosenthal early on in the book introduces her 10 "economic rules of the dysfunctional medical market" which she cites throughout the book to make her point. They include, sadly, counterintuitive truisms such as "More treatment is always better. Default to the most expensive option," "As technologies age, prices can rise rather than fall," "There is no free choice. Patients are stuck," and "More competitors vying for business doesn't mean better prices; it can drive prices up, not down." Rosenthal details how, at every opportunity, healthcare players will exploit every exception, loophole, classification, or special pro- gram to extract more money from patients and, often, Medicare. The book provides an excellent primer as to how things currently work. For example, medical device companies will routinely petition for their products to be reviewed as a class 2 product, which under- goes a less rigorous review and testing process, even though the product is arguably a class 3 product, which must undergo much more testing because it is considered life threatening. Hospitals that have bought physicians' practices will suddenly start billing patients "facility fees" when they visit their same old doctors' offices because the hospitals argue that the office is now an extension of the hospi- tal. Drug makers might stop making an affordable, time-tested generic drug because there isn't much profit to be made; the remain- ing company making the drug might suddenly jack up their generic prices to capitalize on the monopoly they now enjoy on that product. No matter what, patients are the ones that suffer. After she investigates the problem, Rosenthal offers her diagnosis and treatment, and it's here where her book disappoints. After detailing for many, many pages how the profit motive absolutely corrupts the provision of healthcare, she does not fully challenge that fundamental faulty premise that profit should be made off of human illness at all. She buys into the "be a smart consumer" model and makes lots of sugges- tions about how people can advocate for themselves to be more aware of how much healthcare costs and how to bargain down prices and bills. She even includes sample forms in the back to protest charges and such. I suppose it could be helpful, but the template protest forms seem downright laughable compared to the many stories of unscrupulous corporate treachery and scheming that she has just finished relating. Rosenthal does mention single-payer systems and notes that, if the United States is uncomfortable wholly converting to such a sys- tem, that we could phase it in by continuously dropping the age of qualification for Medicare year by year. But she doesn't come out vociferously for any public system that takes the profit out of health- care even though she's just spent hundreds of pages showing why profit has no place in healthcare. There's one place in the book where our organization is mentioned; in the section on hospitals, Rosenthal notes our study on nonprofit hos- pitals that showed nearly 200 hospitals received about "$3.3 billion in state and federal tax exemptions and spent only about $1.4 billion on charity care—a gap of $1.9 billion." Unfortunately, she does not further note our RN organization's alliance with and tremendous advocacy work on behalf of patients, nor mention nurses much at all. She still has very much a physician-focused orientation, and asserts that "doctors 14 N A T I O N A L N U R S E W W W . N A T I O N A L N U R S E S U N I T E D . O R G J U LY | A U G U S T | S E P T E M B E R 2 0 1 6 Frackopoly: The Battle for the Future of Energy and the Environment By Wenonah Hauter The New Press, 2016 In recent years, National Nurses Unit- ed members have become increasingly active in opposing fracking, the process of drilling and fracturing rock deep underground with water, silica, and chemicals to release natural gas, because of the enormous negative health impacts registered nurses see in communities near fracking wells and the long-term environmental and cli- mate disaster nurses know the fossil fuel industry spawns. One of our main allies and an organizational leader against fracking has been Food and Water Watch. Its executive director, Wenonah Hauter, this past year published the definitive and authoritative book detailing the history of, the major players behind, and the growing grassroots resistance to fracking in Frackopoly: The Battle for the Future of Energy and the Environment. If you don't know much about fracking, this book is an excellent primer. Hauter previously authored a similar treat- ment of the corporate food and agribusiness industry titled Foodopoly, and this work is likewise impressive. To discuss modern-day fracking, you have to know the roots and sordid history behind the energy industry in the United States, which has always been a push-pull struggle between oil and gas corporations that unabashedly sought monopoly power and complete market deregulation, and the few government forces that sought to regulate energy as the public resource and utility that it should be considered. She starts from the days of John D. Rockefeller's Standard Oil, to its breakup into the "Baby Standards," to the rise of the Seven Sisters car- tel of oil companies (Gulf Oil, Texaco, Shell, BP, Chevron, Exxon, and Mobil), to the all-out assault started in the 1960s and 1970s by conser- vative economists, business executives, and politicians to repeal the few antitrust laws and regulatory rules we had on the books, and brings us to the frightening, present-day situation we face now. She reveals the roles corporate titans such as John Jay McCloy, Ken Lay, George Mitchell—many of who started, facilitated, or grew major energy companies—played in determining the current landscape. Natural gas has been touted as a "bridge fuel" between clean, renew- able energy and the "dirtier," traditional fossil fuels of coal and oil—a lie that even environmental groups have abetted and allowed energy companies to use as cover for their activities. But make no mistake, natural gas is a finite fossil fuel that must be extracted from the earth. Fracking is believed to contaminate water for millions of Ameri- cans, livestock, and entire ecosystems, exposing them to hazardous, cancer-causing chemicals. In places such as Oklahoma, it's believed to be causing a greater number of and more intense earthquakes. Fracking uses tremendous and intensive amounts of water, often in areas already facing drought and water shortages. Medical providers