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Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price
America's health care system is unraveling. Every day, millions of hard-working people struggle to find affordable medical treatment for themselves and their families—unable to pay for prescription drugs and regular checkups, let alone hospital visits. Some of these people end up losing money. Others end up losing something even more their health or even their lives. In this powerful work of original reportage, Jonathan Cohn travels across the United States—the only country in the developed world that does not guarantee access to medical care as a right of citizenship—to investigate why this crisis is happening and to see firsthand its impact on ordinary Americans. The stories he brings back are tragic and infuriating. In Boston, a heart attack victim becomes a casualty of emergency room overcrowding when she is turned away from the one hospital that could treat her. In South Central L.A., a security guard loses part of his vision when he can't find affordable treatment for his diabetes. In the middle of the prairie heartland, a retired meatpacker sells his house to pay for the medications that keep him and his aging wife alive. And, in a tiny village tucked into the Catskill mountains, a mother of three young children decides against a costly doctor's visit—and lets a deadly cancer go undetected—because her husband's high-tech job no longer provides health insurance. Passionate, illuminating, and often devastating, Sick interweaves these stories with clear-eyed reporting from Washington and takes us inside the medical industry to chronicle the decline of America's health care system—and lays bare the consequences any one of us could suffer if we don't replace it.
320 pages, Hardcover
First published January 1, 2007
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February 13, 2012
With Obamacare now law, perhaps "Sick" is destined to be a work of history— an account of just how dysfunctional health insurance in the United States had become. Throughout the book, author Jonathan Cohn weaves heart-wrenching personal stories alongside health politics and policy in his diagnosis of the ills of the health care system.
Be warned, however, if you prefer to learn about health care from people shouting loud noises at you (SOCIALISM!): this may not be your cup of tea.
The unyielding narrative of "Sick" is that people—good people—who do the right thing in life end up getting the short straw when it comes to health care. This leads to personal and professional trauma for millions of Americans. Moreover, even Americans with health insurance are navigating a system so riddled with inefficiencies that it’s literally bankrupting the United States.
It’s impossible to read this book and believe that what we had was working. Hopefully, "Sick" will serve as a reminder that health reform was, and is, urgently needed in the United States.
Be warned, however, if you prefer to learn about health care from people shouting loud noises at you (SOCIALISM!): this may not be your cup of tea.
The unyielding narrative of "Sick" is that people—good people—who do the right thing in life end up getting the short straw when it comes to health care. This leads to personal and professional trauma for millions of Americans. Moreover, even Americans with health insurance are navigating a system so riddled with inefficiencies that it’s literally bankrupting the United States.
It’s impossible to read this book and believe that what we had was working. Hopefully, "Sick" will serve as a reminder that health reform was, and is, urgently needed in the United States.
November 11, 2016
My friend Jonathan Cohn has found a fantastic way to explain to somebody like me what's wrong with Medicine in the US.
Every chapter of the book is the story of another patient in another city:
Gary Rotzler from Gilbertsville, NY, lost the medical insurance that came with his high-paid aerospace job when he was made redundant in 1993. He did find work, and did so very promptly, but not work that offered him medical benefits, because by the mid-nineties the aerospace sector was feeling the squeeze from defence cuts. His wife Betsy's breast cancer went undetected and by the time it had metastacized to the spine there was little that could be done. Merely going through the motions of offering her the best possible care under the circumstances led Gary to personal bankruptcy and left him wondering if regular health care for Betsy would have allowed her to detect the cancer earlier, live longer and help Gary care that much longer for their three children. His and Betsy's story demonstrates the slow-moving disaster that is unfolding across America in an age when neither employment is for life nor companies (or entire business sectors) can be expected to last for one's entire career.
Janice Ramsey, a fifty-something realtor in Deltona, FL was a successful woman. After sending off five children to college she decided to work for herself; only then did she realise her diabetes made her uninsurable. After two years of looking for a plan (with applications to prove this) she was pleased to finally find a policy to suit her needs. Except American Benefit, that collected USD 365 per month from her to provide her this policy, was a scam, part of a third wave of insurance scams in the history of American medicine. Her story ends better than Gary's when she eventually gets a realtor's licence, which entitles her to insurance via a bank that offers it to realtors who work with it. But it highlights the plight of Americans seeking individual health insurance who happen to have a prior condition.
Elizabeth and Steven Hilsabeck of Lakeside, TX were lucky to have health insurance arranged through a prominent HMO because the hospital bills they ran from having premature twins were in the hundreds of thousands and their HMO picked up the whole thing. But when one of the two twins, their son Parker, was eventually diagnosed with cerebral palsy, their plan did not cover the USD 1000 per month of his physical therapy, because not only was there no proof it would work, but Parker had never walked before (duh!) and thus the therapy would be "habilitative" rather than "rehabilitative." The couple lost their home to medical bills and also lost their marriage, but the story does have a happy ending of sorts, because Parker now walks. Jonathan uses this story as an opportunity to take the reader through the entire history of HMOs in America (It's very interesting!) and to point out the main problem associated with the cover they provide, namely that they define upfront what you'll get from them and that's your lot: rather than say "we'll take care of whatever it is you'll get" it's more along the lines of "here's what we'll treat and here's for how long and good luck to you if something else happens."
Next stop is Sioux Falls, SD, where Lester Sampson had retired after 30 years with his (and his father's) employer, meatpacker J.P. Morrell, safe in the knowledge that he had a double safety net for his and his wife Audrey's health: Medicare and access to enhanced medical coverage from his former employer, in part thanks to having foregone (USD 100 per month) higher pension payments in favor of investing in the best possible health plan. In 1991, the company was taken over by a conglomerate which cancelled the health plan. When the retirees sued, the court split down party lines and decided two-to-one in favour of the employer. Lester and Audrey lost their mobile home to their healthcare costs, but at least eventually found a way to get their hands on the drugs they needed through the VA and Medicare; other former employees were less lucky, leading even to a suicide. Jonathan uses this story as a springboard to take the reader through the depredations visited upon Medicare by Clinton and Bush 43.
Larger-than-life Ernie Maldonado came from Puerto Rico with 5 dollars in his pocket age 14 and eventually settled at age 55 in Lawrence County, Tennessee, where he established a successful auto painting business with his wife Wanda. A rough life of inhaling industrial fumes and exposure to lead from paint left Ernie battling neuropathy, atherosclerosis, poor lungs and diabetes, but Tenn Care had him covered, until in the 1990's it was cut to the bone, ironically by a Democratic governor and former HMO founder and CEO, to help the State make its budget. Only five of Ernie's more than two dozen medications continued to be covered by Tenn Care and he did not live long enough to make it through to the partial reversal of the healthcare cuts that followed.
Chicago is next on the map and the unlikely heroine here is Marijon Binder, who was dismissed from her order as a Catholic nun after 35 years of service when she decided to defy her superior's instructions to return to California and remained in Chicago to continue taking care of an elderly volunteer, Eleanor, whose health had been deteriorating. When Marijon was hospitalized at the Resurrection Medical Center, a Catholic institution, following an incident that looked and felt a lot like a heart attack, but wasn't, and despite having been admitted into an ER where a sign was clearly displayed, indicating care would be offered to all, the last thing she was expecting was a large medical bill. But that's what she got. She appealed to her former colleagues who ran the institution, but to no avail. In contrast to most people who find themselves in her situation, she was educated and articulate. When the hospital's case was heard in court (for Marijon simply did not have the funds to settle the bill), she might not have had the law totally on her side, but she won over the judge, by pointing out (among other things) that the costs presented to her vastly exceeded what the hospital would be charging her insurer (had she been insured). Others are not as lucky and Jonathan uses this chapter to take his readers through the proud history and current diminished status of Catholic hospitals in America.
From Chicago we're off to the roughest neighbourhood in LA, where Tony Montenegro, an avid reader and aspiring accountant, moved from El Salvador to live his American dream. The story is told in medias res. It starts with Tony narrowly avoiding a car accident as his vision slowly goes away during his drive home from work. When he wakes up in the morning he's totally blind. The cause is diabetes that he has refused to treat because he can't afford the medicine. Jonathan details how health care for residents of the poorest parts of LA is no better than in the third world, with nearly half of the working-age adults having no health insurance, because the complex web of programs offering healthcare to the poor is quasi-impossible to navigate. While we're at it, we also explore the Los Angeles County-University hospital, better known from the credits to TV show General Hospital, and its days-long waiting room queue. The point is made that this can't be really be happening in the most advanced country in the world. At the same time, the story ends with Tony finding a workable solution for his healthcare needs, albeit at a point where it's too late to restore his health, eyesight and ability to work to where it had been before he was diagnosed.
Denver is the last stop and the most heartbreaking story, that of Gina Doren, a former child abuse victim who was hospitalized with severe mental disorders shortly after giving birth to her son Kory. Her husband Ross was lucky to have a solid job as a teacher, with full health benefits for his whole family. But the point is made that mental illness has pariah status within the American healthcare system. Even Russ's gold-plated healthcare benefits only allowed for a fixed number of days of hospitalization for mental health. After years of moving in and out of hospitals, with as many as three years of good mental health in a row, Gina deteriorated suddenly when her mom asked to see Kory more. When the fifty days of coverage ran out and Russ ran out of cash, she had to be admitted into a program that would only take care of her during the day. This gave her the opportunity (i) to get her hands on enough prescription drugs to overdose and (ii) allow the suicide attempt go unnoticed for longer than previous, unsuccessful attempts at her own life, much as this last, successful, attempt could well have been another "cry for help."
So there you have it:
1. Tying medical benefits to employment is problematic in a world where people change jobs and companies last longer than a lifetime
2. Tying medical benefits to employment is problematic for the self-employed, who are essentially no different than the unemployed
3. Allowing insurers to turn away those with prior medical conditions turns on its head the whole concept of insurance, whereby the healthy pay for the ill. The converse, however, is equally pernicious because it presents the insurance industry with the problem whereby only the ill or potentially ill purchase insurance, while the provisionally healthy free-ride.
4. HMOs do reduce costs by cutting administrative costs, but competition eventually leads them to also restricting coverage.
5. States that once offered decent healthcare have had to curtail entire programs or else they won't make budget, which they are not constitutionally allowed to do.
6. Charities that once offered decent healthcare have been forced to act more and more like the for-profit institutions they once supplemented, down to the seediest practices like overcharging the uninsured.
7. Parts of America are now offering healthcare that in some respects is of third-world quality
8. Mental health has pariah status in today's American healthcare system.
What is to be done?
Jonathan believes the answer lies in universal coverage. He is not impolite enough to say "the rest of the civilized world does it that way, about time the US joined." Instead he mentions that France, the UK, Germany, Switzerland and sundry Scandinavian nations all spend about half as much on healthcare as the US as a percent of GDP while delivering similar average results and fewer total failures.
And that's QED as far as he's concerned.
I hear you, Jon, but you need to do better than that!
The advocates of the current system are not really denying these stories, as much as they are saying a bunch of very different things. In no particular order:
1. All major medical advances in the world are still happening in the US. Like, yesterday morning, as I was finishing this book, came out the story that they have developed drugs that marshall the resources of the immune system to successfully fight lung cancer. This did not happen in France, the UK, Germany or Scandinavia, did it? It happened in the country where there's serious profit to be made in finding new cures to illness.
2. Yes, at 17% or whatever the GDP proportion is that the US spends on healthcare, America is spending double than the UK give-or-take. But that's because there's tons of rich people in America and health is the ultimate good. The richer the rich get, the more they will spend on healthcare.
3. You can solve both the free-rider problem and the adverse selection problem by making healthcare mandatory for everybody, like you do for car insurance. This means everybody must buy it and everybody must accept to insure everybody, and it's pretty much what Obamacare (Romneycare, call it what you like) can do.
Equally, there are arguments in favor of universal, government-supplied coverage that I was hoping to hear, but again didn't. In no particular order, again:
1. There needs to be a central system that accumulates and aggregates all knowledge that relates to results. We cannot afford the balkanized knowledge about both medical procedures and the effectiveness of drugs under which we are currently operating.
2. There needs to be a minimum level of public health provision, from which we will all benefit, also via lower costs of having to deal with the ill in the future. With people switching jobs and plans so often in today's economy it is impossible to expect private healthcare to provide this, the invisible hand cannot be entrusted with the provision of public goods.
3. While regular healthcare provision can carry on being privately delivered ad infinitem, anybody who has followed the "23 and me" saga, or reads Willem Buiter, will be exposed to the undeniable truth that sometime in the future we will all have a very good picture of what illness awaits us in the future. This entirely violates the concept of private provision of health insurance. Private companies will continuously jostle to insure the members of the public with the lowest expected future costs.
Ultimately, then, this is a book that appeals only to one thing: our sense of fairness. Is it right that the poor can't pay for their healthcare and the unlucky in the middle class can see the savings of their lifetime disappear just as they are losing a loved one? Is it right that the American system resembles more the law of the jungle and puts the onus on the few sick rather than on the many healthy?
I concur with Jonathan that the answer is "no." It's not fair. It's also very unfair in my view that the provision of health insurance is not subject to any laws like the Sherman Act (a fact that the book mentions very obliquely). But I equally know that this is a matter of opinion. Taste, if you like.
I would have liked to see him tackle more facets of the healthcare problem. Maybe in the next book!
Every chapter of the book is the story of another patient in another city:
Gary Rotzler from Gilbertsville, NY, lost the medical insurance that came with his high-paid aerospace job when he was made redundant in 1993. He did find work, and did so very promptly, but not work that offered him medical benefits, because by the mid-nineties the aerospace sector was feeling the squeeze from defence cuts. His wife Betsy's breast cancer went undetected and by the time it had metastacized to the spine there was little that could be done. Merely going through the motions of offering her the best possible care under the circumstances led Gary to personal bankruptcy and left him wondering if regular health care for Betsy would have allowed her to detect the cancer earlier, live longer and help Gary care that much longer for their three children. His and Betsy's story demonstrates the slow-moving disaster that is unfolding across America in an age when neither employment is for life nor companies (or entire business sectors) can be expected to last for one's entire career.
Janice Ramsey, a fifty-something realtor in Deltona, FL was a successful woman. After sending off five children to college she decided to work for herself; only then did she realise her diabetes made her uninsurable. After two years of looking for a plan (with applications to prove this) she was pleased to finally find a policy to suit her needs. Except American Benefit, that collected USD 365 per month from her to provide her this policy, was a scam, part of a third wave of insurance scams in the history of American medicine. Her story ends better than Gary's when she eventually gets a realtor's licence, which entitles her to insurance via a bank that offers it to realtors who work with it. But it highlights the plight of Americans seeking individual health insurance who happen to have a prior condition.
Elizabeth and Steven Hilsabeck of Lakeside, TX were lucky to have health insurance arranged through a prominent HMO because the hospital bills they ran from having premature twins were in the hundreds of thousands and their HMO picked up the whole thing. But when one of the two twins, their son Parker, was eventually diagnosed with cerebral palsy, their plan did not cover the USD 1000 per month of his physical therapy, because not only was there no proof it would work, but Parker had never walked before (duh!) and thus the therapy would be "habilitative" rather than "rehabilitative." The couple lost their home to medical bills and also lost their marriage, but the story does have a happy ending of sorts, because Parker now walks. Jonathan uses this story as an opportunity to take the reader through the entire history of HMOs in America (It's very interesting!) and to point out the main problem associated with the cover they provide, namely that they define upfront what you'll get from them and that's your lot: rather than say "we'll take care of whatever it is you'll get" it's more along the lines of "here's what we'll treat and here's for how long and good luck to you if something else happens."
Next stop is Sioux Falls, SD, where Lester Sampson had retired after 30 years with his (and his father's) employer, meatpacker J.P. Morrell, safe in the knowledge that he had a double safety net for his and his wife Audrey's health: Medicare and access to enhanced medical coverage from his former employer, in part thanks to having foregone (USD 100 per month) higher pension payments in favor of investing in the best possible health plan. In 1991, the company was taken over by a conglomerate which cancelled the health plan. When the retirees sued, the court split down party lines and decided two-to-one in favour of the employer. Lester and Audrey lost their mobile home to their healthcare costs, but at least eventually found a way to get their hands on the drugs they needed through the VA and Medicare; other former employees were less lucky, leading even to a suicide. Jonathan uses this story as a springboard to take the reader through the depredations visited upon Medicare by Clinton and Bush 43.
Larger-than-life Ernie Maldonado came from Puerto Rico with 5 dollars in his pocket age 14 and eventually settled at age 55 in Lawrence County, Tennessee, where he established a successful auto painting business with his wife Wanda. A rough life of inhaling industrial fumes and exposure to lead from paint left Ernie battling neuropathy, atherosclerosis, poor lungs and diabetes, but Tenn Care had him covered, until in the 1990's it was cut to the bone, ironically by a Democratic governor and former HMO founder and CEO, to help the State make its budget. Only five of Ernie's more than two dozen medications continued to be covered by Tenn Care and he did not live long enough to make it through to the partial reversal of the healthcare cuts that followed.
Chicago is next on the map and the unlikely heroine here is Marijon Binder, who was dismissed from her order as a Catholic nun after 35 years of service when she decided to defy her superior's instructions to return to California and remained in Chicago to continue taking care of an elderly volunteer, Eleanor, whose health had been deteriorating. When Marijon was hospitalized at the Resurrection Medical Center, a Catholic institution, following an incident that looked and felt a lot like a heart attack, but wasn't, and despite having been admitted into an ER where a sign was clearly displayed, indicating care would be offered to all, the last thing she was expecting was a large medical bill. But that's what she got. She appealed to her former colleagues who ran the institution, but to no avail. In contrast to most people who find themselves in her situation, she was educated and articulate. When the hospital's case was heard in court (for Marijon simply did not have the funds to settle the bill), she might not have had the law totally on her side, but she won over the judge, by pointing out (among other things) that the costs presented to her vastly exceeded what the hospital would be charging her insurer (had she been insured). Others are not as lucky and Jonathan uses this chapter to take his readers through the proud history and current diminished status of Catholic hospitals in America.
From Chicago we're off to the roughest neighbourhood in LA, where Tony Montenegro, an avid reader and aspiring accountant, moved from El Salvador to live his American dream. The story is told in medias res. It starts with Tony narrowly avoiding a car accident as his vision slowly goes away during his drive home from work. When he wakes up in the morning he's totally blind. The cause is diabetes that he has refused to treat because he can't afford the medicine. Jonathan details how health care for residents of the poorest parts of LA is no better than in the third world, with nearly half of the working-age adults having no health insurance, because the complex web of programs offering healthcare to the poor is quasi-impossible to navigate. While we're at it, we also explore the Los Angeles County-University hospital, better known from the credits to TV show General Hospital, and its days-long waiting room queue. The point is made that this can't be really be happening in the most advanced country in the world. At the same time, the story ends with Tony finding a workable solution for his healthcare needs, albeit at a point where it's too late to restore his health, eyesight and ability to work to where it had been before he was diagnosed.
Denver is the last stop and the most heartbreaking story, that of Gina Doren, a former child abuse victim who was hospitalized with severe mental disorders shortly after giving birth to her son Kory. Her husband Ross was lucky to have a solid job as a teacher, with full health benefits for his whole family. But the point is made that mental illness has pariah status within the American healthcare system. Even Russ's gold-plated healthcare benefits only allowed for a fixed number of days of hospitalization for mental health. After years of moving in and out of hospitals, with as many as three years of good mental health in a row, Gina deteriorated suddenly when her mom asked to see Kory more. When the fifty days of coverage ran out and Russ ran out of cash, she had to be admitted into a program that would only take care of her during the day. This gave her the opportunity (i) to get her hands on enough prescription drugs to overdose and (ii) allow the suicide attempt go unnoticed for longer than previous, unsuccessful attempts at her own life, much as this last, successful, attempt could well have been another "cry for help."
So there you have it:
1. Tying medical benefits to employment is problematic in a world where people change jobs and companies last longer than a lifetime
2. Tying medical benefits to employment is problematic for the self-employed, who are essentially no different than the unemployed
3. Allowing insurers to turn away those with prior medical conditions turns on its head the whole concept of insurance, whereby the healthy pay for the ill. The converse, however, is equally pernicious because it presents the insurance industry with the problem whereby only the ill or potentially ill purchase insurance, while the provisionally healthy free-ride.
4. HMOs do reduce costs by cutting administrative costs, but competition eventually leads them to also restricting coverage.
5. States that once offered decent healthcare have had to curtail entire programs or else they won't make budget, which they are not constitutionally allowed to do.
6. Charities that once offered decent healthcare have been forced to act more and more like the for-profit institutions they once supplemented, down to the seediest practices like overcharging the uninsured.
7. Parts of America are now offering healthcare that in some respects is of third-world quality
8. Mental health has pariah status in today's American healthcare system.
What is to be done?
Jonathan believes the answer lies in universal coverage. He is not impolite enough to say "the rest of the civilized world does it that way, about time the US joined." Instead he mentions that France, the UK, Germany, Switzerland and sundry Scandinavian nations all spend about half as much on healthcare as the US as a percent of GDP while delivering similar average results and fewer total failures.
And that's QED as far as he's concerned.
I hear you, Jon, but you need to do better than that!
The advocates of the current system are not really denying these stories, as much as they are saying a bunch of very different things. In no particular order:
1. All major medical advances in the world are still happening in the US. Like, yesterday morning, as I was finishing this book, came out the story that they have developed drugs that marshall the resources of the immune system to successfully fight lung cancer. This did not happen in France, the UK, Germany or Scandinavia, did it? It happened in the country where there's serious profit to be made in finding new cures to illness.
2. Yes, at 17% or whatever the GDP proportion is that the US spends on healthcare, America is spending double than the UK give-or-take. But that's because there's tons of rich people in America and health is the ultimate good. The richer the rich get, the more they will spend on healthcare.
3. You can solve both the free-rider problem and the adverse selection problem by making healthcare mandatory for everybody, like you do for car insurance. This means everybody must buy it and everybody must accept to insure everybody, and it's pretty much what Obamacare (Romneycare, call it what you like) can do.
Equally, there are arguments in favor of universal, government-supplied coverage that I was hoping to hear, but again didn't. In no particular order, again:
1. There needs to be a central system that accumulates and aggregates all knowledge that relates to results. We cannot afford the balkanized knowledge about both medical procedures and the effectiveness of drugs under which we are currently operating.
2. There needs to be a minimum level of public health provision, from which we will all benefit, also via lower costs of having to deal with the ill in the future. With people switching jobs and plans so often in today's economy it is impossible to expect private healthcare to provide this, the invisible hand cannot be entrusted with the provision of public goods.
3. While regular healthcare provision can carry on being privately delivered ad infinitem, anybody who has followed the "23 and me" saga, or reads Willem Buiter, will be exposed to the undeniable truth that sometime in the future we will all have a very good picture of what illness awaits us in the future. This entirely violates the concept of private provision of health insurance. Private companies will continuously jostle to insure the members of the public with the lowest expected future costs.
Ultimately, then, this is a book that appeals only to one thing: our sense of fairness. Is it right that the poor can't pay for their healthcare and the unlucky in the middle class can see the savings of their lifetime disappear just as they are losing a loved one? Is it right that the American system resembles more the law of the jungle and puts the onus on the few sick rather than on the many healthy?
I concur with Jonathan that the answer is "no." It's not fair. It's also very unfair in my view that the provision of health insurance is not subject to any laws like the Sherman Act (a fact that the book mentions very obliquely). But I equally know that this is a matter of opinion. Taste, if you like.
I would have liked to see him tackle more facets of the healthcare problem. Maybe in the next book!
November 13, 2009
Through a series of case studies which encompass the country from
New York to California,Mr.Cohn illustrates the inadequacies of our
present health care system.He vividly portrays the perils of job loss
as it affects the loss of health insurance.Further, he shows how many,
thinking they have good coverage,frequently find that they have very
little. Then there's the saga of the overburdened emergency rooms popu-
lated by those without insurance. It is estimated that those with insur-
ance pay an extra thousand dollars a year to cover these poor souls.
One of the best features of the book is the background histories
presented about such organizations as Blue Cross and the Kaiser health
plan. Originally a cooperative for its members benefit, Blue Cross has
become a hugely profitable insurance company. Moreover,he shows how our
health insurance became tied to our workplace during World War II.
Finally, Cohn continually stresses the moral obligation of our
society to provide health care for all its citizens.If you really want
to understand the problems in our health care system,how it got that way
and what we can do about it,you can find no better work than this.
September 7, 2008
It's simply written, but a clear narrative of why a privatized health care system that used to work now doesn't, plus explains the exponential rise in costs, especially for the self-employed
March 3, 2010
Published two years ago, Jonathan Cohn’s Sick is an excellent primer for today’s clamorous healthcare debate. Each chapter concerns a particular person or family who fall victim to the ambiguities, deregulation and predation of the American healthcare system and later suffer detrimental financial times.
The people in Cohn’s book aren’t indigent or overtly irresponsible, but rather decent, lower-to-middle class citizens with jobs, ambitions and a desire to live happily. However, they fall into tough times as a result of an illness or incident that clashes with their healthcare provider or, as a consequence of cutbacks, lack thereof. Cohn then takes a step back and outlines the relevant history of our healthcare system to provide the explanation for each person’s individual predicament. Because of this structure, the book narrowly avoids becoming a collection of sob stories.
It only takes three chapters to recognize the pattern: a person or couple is living happily and happily insured, someone comes down with something, the healthcare system shows initial signs of contention, small steps may be taken to ameliorate the situation which ultimately favors the system, thrusting the patients into debt. Cohn admits that he has cherry picked these examples to illustrate the direst circumstances that may befall even young, robust and confidently employed people. We have the professional whose diabetes caused her insurance company to cite the reviled concept of preexisting conditions to terminate her coverage; the young couple whose newborn twins require intensive hospital care that exceeds what their insurance plan is willing to cover; the retiree whose retirement plan is irreparably slashed by his employer; to the husband relying on his insurance to provide psychiatric help for his suicidal wife only to argue with his provider over its necessity.
Although the book focuses most on the people who bear the burden of a dysfunctional system, it also discusses the history and variations of the system. Cohn details the emergence of the healthcare system, the rise of HMOs, the creation of Medicare and Medicaid, and often makes reference to the polarizing concept of a national (more notoriously known as “universal”) healthcare system, citing efforts from previous presidents from Harry Truman to Bill Clinton. Along the way, he joins progressives in advocating such a system, touting the successes of countries such as France, Canada and Japan, whose healthcare isn’t perfect but certainly affordable and of high quality. To supplement his support, he criticizes the Bush Administration and conservatives for encouraging providers to act like businesses first, rooting for their bottom line over the health of their customers.
The book was published in 2007, before the debate on healthcare could even reach the general election. However, his final chapter is very prophetic when it describes an imminent shift toward people-first politics, especially in regards to the healthcare system. Given the extremely vociferous debate over the matter in Washington, it’s safe to assume that Cohn guessed correctly. The pessimist will argue that the current tug of war over healthcare is only a louder extension of a long-standing and remarkably consistent historical dialogue. But given the worsening conditions plaguing the middle class, detailed in heartbreaking detail in Sick, it is crystal clear that reform is vital to the health of the nation, and more importantly, its citizens.
The people in Cohn’s book aren’t indigent or overtly irresponsible, but rather decent, lower-to-middle class citizens with jobs, ambitions and a desire to live happily. However, they fall into tough times as a result of an illness or incident that clashes with their healthcare provider or, as a consequence of cutbacks, lack thereof. Cohn then takes a step back and outlines the relevant history of our healthcare system to provide the explanation for each person’s individual predicament. Because of this structure, the book narrowly avoids becoming a collection of sob stories.
It only takes three chapters to recognize the pattern: a person or couple is living happily and happily insured, someone comes down with something, the healthcare system shows initial signs of contention, small steps may be taken to ameliorate the situation which ultimately favors the system, thrusting the patients into debt. Cohn admits that he has cherry picked these examples to illustrate the direst circumstances that may befall even young, robust and confidently employed people. We have the professional whose diabetes caused her insurance company to cite the reviled concept of preexisting conditions to terminate her coverage; the young couple whose newborn twins require intensive hospital care that exceeds what their insurance plan is willing to cover; the retiree whose retirement plan is irreparably slashed by his employer; to the husband relying on his insurance to provide psychiatric help for his suicidal wife only to argue with his provider over its necessity.
Although the book focuses most on the people who bear the burden of a dysfunctional system, it also discusses the history and variations of the system. Cohn details the emergence of the healthcare system, the rise of HMOs, the creation of Medicare and Medicaid, and often makes reference to the polarizing concept of a national (more notoriously known as “universal”) healthcare system, citing efforts from previous presidents from Harry Truman to Bill Clinton. Along the way, he joins progressives in advocating such a system, touting the successes of countries such as France, Canada and Japan, whose healthcare isn’t perfect but certainly affordable and of high quality. To supplement his support, he criticizes the Bush Administration and conservatives for encouraging providers to act like businesses first, rooting for their bottom line over the health of their customers.
The book was published in 2007, before the debate on healthcare could even reach the general election. However, his final chapter is very prophetic when it describes an imminent shift toward people-first politics, especially in regards to the healthcare system. Given the extremely vociferous debate over the matter in Washington, it’s safe to assume that Cohn guessed correctly. The pessimist will argue that the current tug of war over healthcare is only a louder extension of a long-standing and remarkably consistent historical dialogue. But given the worsening conditions plaguing the middle class, detailed in heartbreaking detail in Sick, it is crystal clear that reform is vital to the health of the nation, and more importantly, its citizens.
August 6, 2016
Read this in preparation for attending a debate sponsored by the Benjamin Rush Institute (BenjaminRushInstitute.org/calandar) at the Medical College of Wisconsin on Feb. 13th. (Jonathan Cohn, a senior editor at The New Republic and frequent writer on healthcare matters, will be one of the debaters.
This book consists of stories on people who have struggled to obtain medical care - and for a variety of reason ran into significant problems:
Losing insurance b/c of losing one's job. The steady decline of employers offering health insurance. The high cost of medical care - making it unaffordable for those without insurance - and increasing HI premiums past affordability too. The effects of medical debt. The problem of pre-existing conditions. Insurance company scams.
Intertwined with the stories, Cohn provides a brief history of the development of health insurance in the US - but typical of someone with a liberal point of view, he fails to appreciate the role that government has played in distorting the health insurance market, leading to most of today's dysfunctions.
(Early on in the book, Cohn disparages the HI offered by Wal-Mart - which is particularly ironic as Wal-Mart's insurance has been found to be better than many of the plans offered through the ACA exchanges.)
The stories are heart-breaking. But Cohn comes at them from the viewpoint that medical care is a social responsibility that needs to be guaranteed by the government. This blinds him to the part that laws and regulations have played in pricing so many people out of affordable medical care. And - it means his solutions are to have even more government control.
There is no logical connection between heart-breaking stories and the need for more government. it is up to those of us who believe in in the power of civil society and markets to explain why they provide superior solutions.
This book consists of stories on people who have struggled to obtain medical care - and for a variety of reason ran into significant problems:
Losing insurance b/c of losing one's job. The steady decline of employers offering health insurance. The high cost of medical care - making it unaffordable for those without insurance - and increasing HI premiums past affordability too. The effects of medical debt. The problem of pre-existing conditions. Insurance company scams.
Intertwined with the stories, Cohn provides a brief history of the development of health insurance in the US - but typical of someone with a liberal point of view, he fails to appreciate the role that government has played in distorting the health insurance market, leading to most of today's dysfunctions.
(Early on in the book, Cohn disparages the HI offered by Wal-Mart - which is particularly ironic as Wal-Mart's insurance has been found to be better than many of the plans offered through the ACA exchanges.)
The stories are heart-breaking. But Cohn comes at them from the viewpoint that medical care is a social responsibility that needs to be guaranteed by the government. This blinds him to the part that laws and regulations have played in pricing so many people out of affordable medical care. And - it means his solutions are to have even more government control.
There is no logical connection between heart-breaking stories and the need for more government. it is up to those of us who believe in in the power of civil society and markets to explain why they provide superior solutions.
July 19, 2009
Jonathan Cohn does an amazing job of addressing our current heath care situation.
This book was not a rant nor was it a dry policy piece. Cohn does a fantastic job of weaving the history of American health care in with case studies of people of different ages, from different backgrounds, from different regions of the country and who had different problems with the healthcare system. He then put each situation in its proper context in history and policy so that he could explain why these things happen and show that they were not just flukes.
Cohn's breadth of coverage is also very expansive. He covers Medicare, Medicaid, mental health coverage, HMOs (and other managed care systems), insurance for small business owners, independent contractors, and several other issues in an amazingly seamless and thorough way.
For those who are worried about availability, quality, and/or cost of healthcare in this country (which should be everyone) I can't recommend this book highly enough.
This book was not a rant nor was it a dry policy piece. Cohn does a fantastic job of weaving the history of American health care in with case studies of people of different ages, from different backgrounds, from different regions of the country and who had different problems with the healthcare system. He then put each situation in its proper context in history and policy so that he could explain why these things happen and show that they were not just flukes.
Cohn's breadth of coverage is also very expansive. He covers Medicare, Medicaid, mental health coverage, HMOs (and other managed care systems), insurance for small business owners, independent contractors, and several other issues in an amazingly seamless and thorough way.
For those who are worried about availability, quality, and/or cost of healthcare in this country (which should be everyone) I can't recommend this book highly enough.
September 10, 2008
"Most Americans still have health insurance and, more often than not, they're reasonably happy with it. They know that millions of Americans aren't so lucky, but, according to the polls, they have a hard time imagining themselves in that situation. (They continue to believe, for example, that most people without insurance are unemployed.) Similarly, while they grasp that the uninsured don't always get the same quality care as people with coverage, they still think the uninsured get medical attention when they need it.
...the stores in this book are not so much representative as indicative -- indicative of what can happen even to hardworking, intelligent people when their need for medical care overwhelms their ability to pay for it."
...the stores in this book are not so much representative as indicative -- indicative of what can happen even to hardworking, intelligent people when their need for medical care overwhelms their ability to pay for it."
October 8, 2007
This book was well researched and had a format that was satisfying in a "Law and Order" sort of way (each chapter introduces a real person battling the health care system then pulls back to put that person's struggles in context). It clearly spells out the history of our health care system, and the many ways in which it's failing nearly everyone, with enough "real person" detail to get you in the gut. So why just three stars? I guess because I knew much of what Cohn writes about already. I've read a fair amount about this topic, though, so perhaps this would be a good introduction for people who aren't yet aware of all the flaws in our health care system. If there are any people like that.
September 11, 2009
I started this book on the subway and cried through the first 25 pages. After that things tapered off, although I still welled up at least once every chapter.
Cohn did an amazing job of making the history and current status of our health care system interesting to read - I didn't ever feel like I HAD to keep reading; I just WANTED to keep reading!
Everyone who wants to know how and why our current health care system operates the way it does should read this book!
Cohn did an amazing job of making the history and current status of our health care system interesting to read - I didn't ever feel like I HAD to keep reading; I just WANTED to keep reading!
Everyone who wants to know how and why our current health care system operates the way it does should read this book!
June 24, 2014
2.5* really. I enjoyed the stories Cohn shared, and I appreciate his perspective. I agree wholeheartedly that the American healthcare needs a serious revamp. Though I have never been registered as anything but independent, I would have had a much easier time being convinced by his arguments if he hadn't been quite so partisan. While he gives both republicans and democrats their dues where he feels they are merited, you'd think that Kennedy and his administration single-handedly rescued the entire healthcare program. The anecdotes Cohn uses definitely grab the attention of the reader, and he is careful to point out that each one is representative of a much larger population. I couldn't help but feel like his synopsis of the republican perspective was perhaps a bit too hasty. They are presented as folks who just don't understand the healthcare crisis and have no compassion whatever about it. Since Kohn's democratic spirit has a tendency to dominate his writing, I was much more skeptical about his presentation of the arguments. I sympathize with the growing number of folks who are uninsured (I just became one again, though currently employed, and this is my third or fourth time losing healthcare), but the practical side of me would argue that programs like Obamacare, Medicaid, etc. have great big aspirations with no dollars to back them. Kohn doesn't disagree here (Obamacare isn't mentioned, as the book's publication predates it), but I can tell you that I deeply resent the idea of my paying for healthcare problems that folks bring on themselves: obesity and the subsequent complications and expenses that accompany it, smoking, drinking, drugs, etc. I have no objection whatever to paying for folks who have health complications over which they have little or no control (MS, cerebral palsy, Type 1 Diabetes, etc.,) Practically speaking, though, it seems impossible to divvy up culpability in any accurate way. I cite my own feelings, because it is one of many reasons folks could have to objecting to universal heath care. You don't have to be a rich, healthy republican to have objections. Kohn lists a few other countries in which different systems of universal health care exist quite successfully: France, Canada, Germany, etc. Neither the populations nor the obesity rates (both of which I imagine to be huge factors in successful duplication of the system/s) compare to the U.S. by a long shot. In any case, I did feel that I learned a lot from reading the book, and I appreciated getting another perspective than my own.
Note: it did not help to discover that Cohn is another murderer of the past participle. "had SHOWN" NOT "had showed" PLEASE!
Note: it did not help to discover that Cohn is another murderer of the past participle. "had SHOWN" NOT "had showed" PLEASE!
September 27, 2009
Jonathan Cohn, a Harvard grad, is a senior editor at The New Republic, contributing editor at The American Prospect and a senior fellow at the think tank Demos. He has also written for The New York Times, The Washington Post, Mother Jones, Rolling Stone, Slate and The Washington Monthly.
I found Sick to be an excellent primer on the U.S. health care system. The subtitle: the untold story of America's health care crisis - and those who pay the price, turns out to be the focus of this book (shocking, I know). I say this with a bit of sarcasm because of some of the reader reviews I've seen that either criticize Cohn for advocating for universal coverage (a topic he spends about 18 pages at the end of the book discussing) or for not throwing enough data, analysis and policy at the reader. This book is about average Americans trying to navigate a perverse and often baffling health care system.
Each chapter highlights a different city (from Boston to Deltona to Sioux Falls and Los Angeles) and a few of its inhabitants as they interface with doctors, hospitals, insurance companies and employers. Several reviews site the use of anecdotes as a weakness but I found them to be the just the opposite. Cohn's use of personal stories aims to engender empathy in the reader and it does so in spades. Each chapter also highlights a different aspect of the system from the history of employer-based health insurance to Medicare and Medicaid to the rise of managed care. The narrative switches back and forth between personal story to policy discussion, but does so in a way that flows naturally. Reviewer Abigail Zuger wrote of Cohn's style: "I suspect that committed policy wonks might find his analysis fairly basic, but for those of us without formal background in the area, it is a pleasure to have the whole drama laid out, act by act."
This book is niether a rant nor propaganda. Cohn is as objective as one can hope to be on the topic. Of the negative reviews I've read, I have yet to come across one that assails the author's investigations, analysis and ultimate portrayal of the health care system. Perhaps this is because Cohn devotes 53 pages to his sources and notes.
I highly recommend this book to anyone looking for a point of entry into the discussion of health care reform. This book has sparked my interest and has spurred me on to read more books on the subject.
I found Sick to be an excellent primer on the U.S. health care system. The subtitle: the untold story of America's health care crisis - and those who pay the price, turns out to be the focus of this book (shocking, I know). I say this with a bit of sarcasm because of some of the reader reviews I've seen that either criticize Cohn for advocating for universal coverage (a topic he spends about 18 pages at the end of the book discussing) or for not throwing enough data, analysis and policy at the reader. This book is about average Americans trying to navigate a perverse and often baffling health care system.
Each chapter highlights a different city (from Boston to Deltona to Sioux Falls and Los Angeles) and a few of its inhabitants as they interface with doctors, hospitals, insurance companies and employers. Several reviews site the use of anecdotes as a weakness but I found them to be the just the opposite. Cohn's use of personal stories aims to engender empathy in the reader and it does so in spades. Each chapter also highlights a different aspect of the system from the history of employer-based health insurance to Medicare and Medicaid to the rise of managed care. The narrative switches back and forth between personal story to policy discussion, but does so in a way that flows naturally. Reviewer Abigail Zuger wrote of Cohn's style: "I suspect that committed policy wonks might find his analysis fairly basic, but for those of us without formal background in the area, it is a pleasure to have the whole drama laid out, act by act."
This book is niether a rant nor propaganda. Cohn is as objective as one can hope to be on the topic. Of the negative reviews I've read, I have yet to come across one that assails the author's investigations, analysis and ultimate portrayal of the health care system. Perhaps this is because Cohn devotes 53 pages to his sources and notes.
I highly recommend this book to anyone looking for a point of entry into the discussion of health care reform. This book has sparked my interest and has spurred me on to read more books on the subject.
August 22, 2010
This is a really good summary of how the American health care system got to be the way it is (or at least the way it was before the new health care bill), and also a very engaging read. Every chapter is based around a different anecdote, each illustrating a different problem with the system. For instance there's a self-employed consultant with diabetes who ends up buying a fradulent health insurance policy, which frames a whole discussion on the individual market, an ex-nun who gets sued by a supposedly non-profit Catholic hospital for non-payment, which talks about the collapse of the charitable hospital system, and so on.
I'm really interested in this topic, personally, being self-employed and older and basically uninsurable (though still in good enough health to run a marathon once or twice a year, go figure), but I wish more people who have insurance would read it. There's a big trapdoor under them that they don't know about that could swing open at any time.
Anyway, highly recommended. Cohn is a senior editor at New Republic and has done some of the best reporting on the health care debate there.
I'm really interested in this topic, personally, being self-employed and older and basically uninsurable (though still in good enough health to run a marathon once or twice a year, go figure), but I wish more people who have insurance would read it. There's a big trapdoor under them that they don't know about that could swing open at any time.
Anyway, highly recommended. Cohn is a senior editor at New Republic and has done some of the best reporting on the health care debate there.
August 25, 2007
Though not actually related in any way, I don't think it's too far off base to call this the calm, wonky book version of Michael Moore's Sicko (a good movie, by the way, if you can look past Moore's exaggerations and the trip to Cuba that ends the film). Both use the stories of individuals screwed by our system to make points about U.S. health policy.
Well-executed, but I found it a bit ponderous on the whole -- though using real people to make the policy discussion more immediate is a good technique, I felt that Cohn spent a bit too much time walking us through sad story after sad story. I would have preferred them as an introdution to each chapter, not the focus. That said, the discussions of policy-type-stuff were very good, and Cohn did an especially good job of explaining how the system evolved into its disfunctional state from sensible and well-meaning beginnings. His conclusion, about universal health care, was also very good, and I wished he spent more than 10 pages on it.
Well-executed, but I found it a bit ponderous on the whole -- though using real people to make the policy discussion more immediate is a good technique, I felt that Cohn spent a bit too much time walking us through sad story after sad story. I would have preferred them as an introdution to each chapter, not the focus. That said, the discussions of policy-type-stuff were very good, and Cohn did an especially good job of explaining how the system evolved into its disfunctional state from sensible and well-meaning beginnings. His conclusion, about universal health care, was also very good, and I wished he spent more than 10 pages on it.
May 30, 2012
In Sick, Cohn offers us fascinating case studies of folks who's plight(s), to him, are indicative of the entire health system's failings. The studies are witty, thoroughly researched and hang together with a bit of historical background that he provides ongoing.
It's a great story - for me, this works entirely, as I generally agree with his conclusions. I believe that he'd have had more success with a broader audience - including perhaps some people who may disagree with his views - if he didn't use "cherry picked" case studies (my terminology) as his primary means of convincing us "something's wrong".
Towards the end of the book, Cohn addresses this issue, noting that the cases he presents are - he believes - as much indicative of trends and behaviours as they are examplars. With all the sympathy towards his perspective in the world, I still found this last section an unconvincing apologia.
For a challenging, but remarkably well-written and informative book on this subject, see Paul Starr's Pulitzer winning "The Social Transformation of American Medicine".
It's a great story - for me, this works entirely, as I generally agree with his conclusions. I believe that he'd have had more success with a broader audience - including perhaps some people who may disagree with his views - if he didn't use "cherry picked" case studies (my terminology) as his primary means of convincing us "something's wrong".
Towards the end of the book, Cohn addresses this issue, noting that the cases he presents are - he believes - as much indicative of trends and behaviours as they are examplars. With all the sympathy towards his perspective in the world, I still found this last section an unconvincing apologia.
For a challenging, but remarkably well-written and informative book on this subject, see Paul Starr's Pulitzer winning "The Social Transformation of American Medicine".
September 2, 2015
This is a book about American Healthcare written in 2007. Using a series of case studies, it illustrates how our healthcare system has failed us. I liked how it went back to the history and origins of health insurance so we could find out why it ended up the way it did. A lot of the more present-time problems I knew, but it was good to see it personified in real people, and I learned a lot about the Medicare system. The only thing I did not like about this book was that it was repetitive. This seems to be a pitfall in many non fiction books. Once an author makes a point, they'll then set up and make it four more times, just in case we didn't get it the first time. I've seen firsthand how much of a hard time some people have comprehending some of these things, so I suppose it's necessary, but it could be more concise. Overall, it was a very informative, easy to read and interesting book. I recommend this book.
June 9, 2007
I currently have health insurance. But as a part-time/ freelancer, I pay a lot for very little. I've been injured while uninsured and it sucks to say the least. I once worked a job I hated for two-and-a-half years just to fix all the stuff that was broken in me from the period I was uninsured. (I ended up severely depressed and in therapy, my insurance covered just 2 visits a month.) It was a risk to quit the job, but it had to be done. I lost the insurance but within 2 years I landed my dream writing job (Well, not having to pay for my own health coverage would make it absolutely perfect.) But I'm now writing about the issue. Sick is a book that not only covers all the basic stops on the train wreck that is the American health care system, but is a very quick and entertaining read (when you're not cringing in empathy or crying because of your own health insurance situation).
May 2, 2012
This book is absolutely fascinating and provides expansive historical and political context for the development of the healthcare system in the United Staes -- from FDR's Social Security Act of 1935 to Truman's attempt at health reform in the 1940s to LBJ's implementation of Medicare and Medicaid in 1965 -- and through the rise of managed care in the 1990s and Clinton-era attempts at universal healthcare. It is peppered with anecdotes that illustrate various flaws in our healthcare system and it offers a very smart look at why it is so difficult to fix those flaws. This book was written before the Affordable Care Act was passed in 2010, but it focuses on problems that are still very relevant today -- and a lot of the context is pertinent to how the ACA ended up being revised in 2010 before it could be passed.
January 1, 2009
Each year, I pick a subject I'm interested in studying on my own and I read as many books as I can. My first year I read something like 11 books on Vietnam. Health care is my second subject of interest.
This is the first book of my year long study of health care. Sick primarily focuses on some of the problems our current health care system faces. At each chapter it presents a true heart breaking story of real people who have suffered. It's sad and an eye opener to health care but it wasn't what I was looking for.
I found what I was looking for in reading "Crisis of Abundance" by Arnold Kling.
This is the first book of my year long study of health care. Sick primarily focuses on some of the problems our current health care system faces. At each chapter it presents a true heart breaking story of real people who have suffered. It's sad and an eye opener to health care but it wasn't what I was looking for.
I found what I was looking for in reading "Crisis of Abundance" by Arnold Kling.
June 8, 2014
Very enlightening--and depressing. Ignorance is bliss. Before I only wondered but now I KNOW I'm on shaky ground.
We know about these things (from the media or personal experiences) but it helps so much to read about it, sequentially, and in illustrated format.
I loved the case histories. They are as refreshing as a picture [which is alleged to be as good as 1,000 words]. Also loved that the sections were sometimes split up geographically, such as the one named Austin, 'cause that's where I am right now.
This book was the prequel to "ObamaCare". I hope this guy writes another one about that, along the same lines.
We know about these things (from the media or personal experiences) but it helps so much to read about it, sequentially, and in illustrated format.
I loved the case histories. They are as refreshing as a picture [which is alleged to be as good as 1,000 words]. Also loved that the sections were sometimes split up geographically, such as the one named Austin, 'cause that's where I am right now.
This book was the prequel to "ObamaCare". I hope this guy writes another one about that, along the same lines.
December 26, 2016
A very interesting well written book. Though this book was written prior to the Affordable Care Act, many of its stories still reign true to an extent and are at threat of coming back to the forefront in the near future. I think this book is a good read if you find yourself at a position that I find myself, questioning how we can do healthcare better in the United States. This book gives a great history of the evolution of healthcare in the US as well as many highlights of the inadequacies and the misunderstandings that the general public has about sheer access to care prior to the Affordable Care Act
August 13, 2009
I really want to understand this enormously complex issue in order to have an informed opinion on it. What I've learned from this book is that the arguments being made against health care reform today are virtually identical to those used repeatedly over the last century--and, alas, they still seem to work. My clearest insight: insurance only works the way it is supposed to when the pools are big and diverse enough to genuinely spread risk around and allow the group as a whole to come out even. But of course, for today's big players, "even" isn't the goal; maximum profit is.
December 29, 2012
A great PERSONAL look at some of the poorer aspects of modern health care. Initially, Cohn gives a succinct history of insurance in the United States, and then uses stories to highlight different aspects of our insurance system that have missed the mark in recent years. A good read for anyone that wants to be a little more informed for the health care debate. Let the topics in this book move you toward the Kaiser Foundation website on the ACA (or something similar), so that you can form your own opinion on the direction our federal government is taking us.
June 29, 2007
I'm quite in favor of universal healthcare, so the author is preaching to the choir here. That being said, I actually found this book tedious. Maybe it's just me. The book has a collection of true tragic healthcare stories from around the country, with a short ending on single-payer systems. Maybe that's what I found tedious -- I already know how broken the system is; I wanted more focus on solutions.
July 30, 2007
In a review of Michael Moore's "Sicko" that I read somewhere on the internets, the reviewer mentioned that Sick is a great companion piece to the movie. It provides the hard data (through documented anecdotes) that Moore's film lacks or glosses, to show that our health-care system is a fiasco.
Sick is a fantastic journalistic work and well worth reading. But be warned: it's difficult to read much in one sitting. It will bring your blood to a rolling boil.
Sick is a fantastic journalistic work and well worth reading. But be warned: it's difficult to read much in one sitting. It will bring your blood to a rolling boil.
February 4, 2008
This is a book that balances the dry history of medical insurance in this country with tearful portraits of Americans whose lives have been destroyed, both physically and financially, by medical catastrophes. Most of these catastrophes could've been either prevented or largely mitigated in a single-payer system of national healthcare. If you understand this concept well enough already, I'd suggest you just rent Sicko instead.
June 24, 2008
I really didn't want to like this book. It's a series of personal stories on how people have been screwed by the health care system, and I couldn't stop thinking that 10 stories can't possibly be a representative sample! But, I actually really enjoyed this book. The stories were used as examples and the author went into the history of each problem. It wasn't quite unbiased enough for my taste, but I don't know if any books on health care are ever unbiased.
October 13, 2009
This was sort of an history of how the US health care system evolved - a bunch of backroom political deals and such are interwoven with tragic tales. I knew some about the topic, but I learned things, and was sucked in - read the whole thing cover to cover in about 2 hours when I finally sat down to read it. Am not sure how it would work on people who think that US Health Care is fine as is, but, I liked it all right.
February 19, 2013
While the individual stories were overly sentimental, the patient scenarios set the stage nicely for the historical account of health insurance in America. This book offered a great review of Medicare, Medicaid, S-CHIP, MCOs, and care for the uninsured. It's ultimately a push for universal health care, told through emotional stories, but altogether an interesting prelude to what may change with the Affordable Care Act.
August 6, 2013
A sad true story about how privatized health care has left people, even insured people behind: a nun sued by a catholic hospital for charges accrued, a fully insured woman who commits suicide shortly after early discharge due to lack or ability to pay company's and folks who are forced to sell their homes and families whom trade months taking their prescribed medications. Oh wait, this is currently happening here.
This entire review has been hidden because of spoilers.
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