Rap and Politics: A Case Study of Panther, Gangster, and Hyphy Discourses in Oakland, CA (1965–2010). By Lavar Pope. New York: Palgrave Macmillan, 2020. 338p. $89.99 cloth.

on healthcare, specifically. As we would expect, Olson’s focus on healthcare emphasizes not only the huge market opportunities healthcare presents in the US, but moral outrage at private equity’s tendency to treat healthcare as just another industry to be exploited, with no special concern for the impact that such financial tactics have on lives. To show private equity’s reach, subsequent chapters explore a wide array of topics, with Olson starkly declaring that “nowadays acquisitions and mergers are skyrocketing in all niches” (p. 127). Perhaps the most disturbing aspects of Olson’s accounting of private equity’s pilfering of American healthcare are her detailed discussions of equity’s rapacious takeover of areas in which patients are particularly vulnerable, such as the largely for-profit home healthcare industry, as well as equity’s deleterious effects on specific disease treatments, from addiction, to autism, to eating disorders. The sweeping examination Olson provides of private equity’s inroads into every corner of the massive American healthcare industry provides a sense of just how far equity’s reach has extended. Depressingly, though honestly, Olson does not offer any reason for us to be optimistic that there are limits to this reach. As she explains in the closing pages of the book, state and federal action will be required if the malignant forces she describes are to be curbed. But given the degree of regulatory and legislative capture that private equity has already accomplished, the reader is given little reason to hope that a progressive democratic politics will arise to serve as a counterweight. Even more concerning is that there is little reason to believe that any lessons were learned from the COVID-19 pandemic, which actually provided investment opportunities for private equity to not only prey upon struggling healthcare practices, but to leverage federal relief funding for shrewd financial gains. Taken together, Swenson and Olson’s books give us different but similarly stark examples of why American healthcare policy continues to frustrate, and especially why progressive reform that puts patients and populations first is so elusive. Critics of American healthcare often fail to train their analyses on the actual forces that ultimately shape American health policy, which are lodged in the institutional underbellies of little-understood entities. While the inner workings of the organizations such as the AMA—the subject of Swenson’s book—are not something most Americans know much about, Olson shows that private equity is actively shrouded in secrecy, and hence extremely difficult to study, even for scholars who admirably dedicate themselves to the cause. Transparency—or the lack thereof—is therefore a unifying theme across both books, whether we are concerned with shadowy advertising and consultancy arrangements, nondisclosure agreements, or other tools of opacity. Even more than transparency, however, readers will be struck by the question of animating values. For Swenson, the question is whether the AMA of the future, in a reversal of the last hundred years of its history, will transform itself to become a force for good within the larger field of American healthcare, especially by making public health and preventive care a priority. Olson’s question is whether private equity’s singular focus on profits can be reined in, especially through federal policy. While the fate of the AMA will be determined in a primarily endogenous manner, as a function of internal deliberations within the body’s House of Delegates, Olson is under no illusion that only congressional action can prevent private equity’s assault on American healthcare. Private equity is, after all, “ethically challenged.” Shorn of the sentimental veneer that allows medical professionals to recite oaths claiming that “doing no harm” is their central concern, these books remind us, in important ways, that medicine is at base just another industry ripe for the picking to those principally interested in reaping profits. There is just too much stakeholder power and investment potential in American medicine to sustain the fiction that medicine somehow operates outside of the vagaries of American capitalism, or that it is a special kind of commodity. Like so many other challenges in American healthcare, the only solution appears to be a revitalized progressive politics—both within organizations and beyond—to reconfigure American healthcare institutions so that they meaningfully operate in the public interest. And yet, few readers are likely to be sanguine about the prospects that such a politics will arise any time soon.