Argues for more transparent, democratic and safer healthcare practices to keep patients better informed and hold poor-performing doctors and flawed systems accountable.

New York Times Bestseller “Every once in a while a book comes along that rocks the foundations of an established order that's seriously in need of being shaken. The modern American hospital is that establishment and Unaccountable is that book.”-Shannon Brownlee, author of Overtreated Dr. Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's bestselling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting. Over the last ten years, neither error rates nor costs have come down, despite scientific progress and efforts to curb expenses. Why? To patients, the healthcare system is a black box. Doctors and hospitals are unaccountable, and the lack of transparency leaves both bad doctors and systemic flaws unchecked. Patients need to know more of what healthcare workers know, so they can make informed choices. Accountability in healthcare would expose dangerous doctors, reward good performance, and force positive change nationally, using the power of the free market. Unaccountable is a powerful, no-nonsense, non-partisan diagnosis for healing our hospitals and reforming our broken healthcare system.

A co-developer of the medical care list outlined in Atul Gawande's best-selling The Checklist Manifesto presents an urgent call for action that advocates more transparent, democratic and safer healthcare practices to keep patients better informed and hold poor-performing doctors and flawed systems accountable.

Dieses Buch befasst sich mit einem topaktuellen und gleichzeitig umstrittenen Thema: die Praktiken von Wirtschaftsprüfungsgesellschaften und der Ruf nach umfassenden Reformen. Die ganze Brisanz dieses Themas wird am Beispiel des Prozesses gegen Arthur Anderson im Fall Enron nur zu deutlich, und die Situation für Wirtschaftsprüfer und ihre Klienten wird zunehmend brenzliger. Anhand von Interviews mit über 100 Hauptakteuren der Prüfungsbranche geht Autor Mike Brewster auf wichtige Gesprächsrunden und Ereignisse ein, die die Weiterentwicklung der Rolle des Wirtschaftsprüfers - weg von der reinen Prüfungspraxis und hin zu Consulting- und Researchaktivitäten bis zu Anlagetipps - deutlich belegen. "Unaccountable" zeichnet die faszinierende Verwandlung des Wirtschaftsprüfers nach, der einst als unabhängige Stimme im Auftrag der Aktionäre handelte und sich mittlerweile in einen Finanzberater für seine Unternehmensklientel verwandelt hat. Mike Brewster hat Kontakt zu einigen der stärksten Befürworter von Reformen sowie zu Brancheninsidern, wie z.B. Arthur Levitt, Harvey Pitt, Sandy Weill und den Vertretern der Großen 5 Wirtschaftsprüfungsunternehmen in den USA. Er stellt unbequeme Fragen und enthüllt dabei den großen Einflussbereich von Prüfern in Vorstandsetage, Wirtschaft und Politik. Denn Prüfer gehen heute lieber ihren Consultingaktivitäten nach als der Rechnungsprüfung; und die Großen 5 sind mehr damit beschäftigt, Prozesse zu führen als an der Verbesserung ihrer Prüfungen zu arbeiten. "Unaccountable" - Dieses Buch diskutiert die wirklich wichtigen Themen, beschreibt Möglichkeiten der Reform und erläutert die Auswirkungen, die diese auf Investoren und die Öffentlichkeit haben werden.

America is highly polarized around elections, but unelected actors make many of the decisions that affect our lives. In this lucid history, James R. Copland explains how unaccountable agents have taken over much of the U.S. government apparatus. Congress has largely abdicated its authority. “Independent” administrative agencies churn out thousands of new regulations every year. Courts have enabled these rulemakers to expand their powers beyond those authorized by law—and have constrained executive efforts to rein in the bureaucratic behemoth. No ordinary citizen can know what is legal and what is not. There are some 300,000 federal crimes, 98 percent of which were created by administrative action. The proliferation of rules gives enormous discretion to unelected enforcers, and the severity of sanctions can be ruinous to citizens who unwittingly violate a regulation. Outside the bureaucracy, private attorneys regulate our conduct through lawsuits. Most of the legal theories underlying these suits were never voted upon by our elected representatives. A combination of historical accident, decisions by judges and law professors, and self-interested advocacy by litigators has built an onerous and expensive legal regime. Finally, state and local officials may be accountable to their own voters, but some reach further afield, pursuing agendas to dictate the terms of national commerce. These new antifederalists are subjecting the citizens of Wyoming and Mississippi to the whims of the electorates of New York and San Francisco—contrary to the constitutional design. In these ways, the unelected have assumed substantial control of the American republic, upended the rule of law, given the United States the world’s costliest legal system, and inverted the Constitution’s federalism. Copland caps off his account with ideas for charting a corrective course back to democratic accountability.

A unique insider's account of the Harper government so damning that it cannot be ignored In March 2008, Kevin Page was appointed by the federal Conservatives to be the country's first Parliamentary Budget Officer. The move fulfilled a Tory campaign promise to deliver greater government transparency and accountability. He was later denounced by the same people who appointed him to scrutinize their spending. When he challenged the government on several issues--most notably about the true costs of the F-35 fighter planes--and publicly claimed the government was misleading Canadians, Page was vilified. He was called "unbelievable, unreliable and incredible" by then-Finance Minister Jim Flaherty. Page's term was not extended and he retired from the civil service. Page's assessment of the F-35 procurement was proven right, a major embarrassment to the Harper government. But Page's overriding concern is that Parliament does not get the information and analysis it needs to hold the executive (the prime minister and cabinet) to account. Parliament, he argues, is broken, with power centralized in the PMO. The civil service appears cowed, and members of parliament almost never see enough financial analysis to support the policy decisions they make. That was true at various times on the tough-on-crime legislation, new military procurement as well as changes to the Canada Health Transfer and Old Age Security. In this shocking insider's account, Page argues that democracy is being undermined by an increasingly autocratic government that does not respect facts that run counter to its political agenda. Elected officials need accurate, independently verified data to support the implementation of policies and programs. In Unaccountable, Page tells all Canadians why we should be concerned.

From the Tea Party to Occupy Wall Street, however divergent their political views, these groups seem united by one thing: outrage over a system of power and influence that they feel has stolen their livelihoods and liberties. Increasingly, protesters on both ends of the political spectrum and the media are using the word “corrupt” to describe an elusory system of power that has shed any accountability to those it was meant to help and govern. But what does corruption and unaccountability mean in today’s world? It is far more toxic and deeply routed than bribery. From Super PACs pouring secret money into our election system, to companies buying better ratings from Standard & Poors, or the exteme influence of lobbyists in congress, all are embody a “new corruption” and remain unaccountable to our society’s supposed watchdogs, which sit idly alongside the same groups that have brought the government, business and much of the military in to their pocket.