After the needless death of his father, the author, a business executive, began a personal exploration of a health-care industry that for years has delivered poor service and irregular quality at astonishingly high cost. It is a system, he argues, that is not worth preserving in anything like its current form. And the health-care reform now being contemplated will not fix it. Here’s a radical solution to an agonizing problem.

During the nineteen-eighties, the American gut, instead of expanding very gradually, had ballooned: 33.3 per cent of adults now qualified as overweight. Flegal began asking around at professional meetings. Had other researchers noticed a change in Americans’ waistlines? They had not. This left her feeling even more perplexed. She knew that errors could have sneaked into the data in a variety of ways, so she and her colleagues checked and rechecked the figures. There was no problem that they could identify. Finally, in 1994, they published their findings in the Journal of the American Medical Association. In just ten years, they showed, Americans had collectively gained more than a billion pounds. “If this was about tuberculosis, it would be called an epidemic,” another researcher wrote in an editorial accompanying the report.

“The running shoe right now is doing nothing for preventing injuries,” said Reed Ferber, director of the Running Injury Clinic at the University of Calgary’s Faculty of Kinesiology. But, he adds, going barefoot has downsides too, and the research so far is still inconclusive. “It’s a total tradeoff.”

Chris McDougall, author of the recent book Born to Run, goes further. “If this were a drug, it would be yanked off the market,” he said of running shoes. McDougall says his own persistent problems with plantar fasciitis cleared up after he started running in Vibram FiveFingers.