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Executive Times |
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2007 Book Reviews |
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Sick: The
Untold Story of America's Health Care Crisis---and the People Who Pay the
Price by Jonathan Cohn |
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Rating: |
*** |
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(Recommended) |
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Click on
title or picture to buy from amazon.com |
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Personal In his new
book, Sick:
The Untold Story of America's Health Care Crisis---and the People Who Pay the
Price, The New Republic’s senior editor Jonathan Cohn puts a human face on
the many ways in which our American approach to health care is failing. Each
page tells the stories about people who feel the effect of policies, many of
which are intended to produce better results. Here’s an excerpt, from the
beginning of Chapter Two, “Deltona,” pp. 27-30: For nearly
two years, Janice Ramsey had been looking for health insurance. And for
nearly two years, she had been failing to find it. Her problem wasn’t lack of
a job. She had
one of those. And it wasn’t lack of money. She had some of that, too. No,
Janice’s problem was lack of health. She had diabetes. It was a problem because Janice happened to be
self-employed: she was a consultant to a home construction company she had
once run with her husband. The work paid well enough. The company was based
in Deltona, a booming suburb north of Janice says that many insurers, once they heard she was
diabetic, told her not to apply at all. The few that considered her
application either declined it outright or refused to cover anything related
to her diabetes—rendering the policies pretty worthless, Janice figured,
since so many medical problems could plausibly be blamed on the condition.
“If I would have had a heart attack or anything else, if my foot fell off,”
she explained in her characteristically tart way, “they would have told me
it’s from diabetes because everything has to do with diabetes from what the
insurance companies feel.” As the
months dragged on and Janice’s medical bills slowly depleted her savings,
she frequently wondered how she had ended up in this situation. At the time,
Janice was in her fifties. Having worked for much of her adult life, she
carried herself like a professional, dressing in elegant business clothes and
carefully styling her lightly colored short hair. Along the way, she had also
managed to raise five children, all of them now in college or in successful
jobs. Just recently, Janice had taken in her own mother, who had become too
sick to live alone. Janice had a hard time imagining that many people worked
harder than she did. And yet here she was, no better
than a pauper as far as American health care was concerned. “It’s
embarrassing,” she later said, “because I’ve never asked anybody for anything
and I don’t like not being able to take care of myself.” That’s why Janice was
so pleased when, in the summer of 2001, a friend told her about a new health
insurance company called American Benefit Plans. American Benefit operated
through professional associations (like realtors and photographers) to bring
the advantages of large-group coverage to people working on their own or in
small business. And on the basis of the plan’s glossy literature, it sounded
like a great deal. American Benefit had its own network of well-respected
doctors and hospitals, including some of the best in the Janice
signed up, and almost immediately the company began deducting the monthly
premiums of around $365 directly from her bank account, as she’d authorized
it to do. For a few months, the coverage seemed to be everything she had
hoped it would be. She was able to take care of her routine needs, from the
medication she used to help control her blood sugar to the checkups diabetics
are supposed to get four times a year. She was able to take care of more
serious problems, too, including a hospitalization after she collapsed in her
home. Fearing that Janice was having a heart attack, the doctors had gone
ahead and performed cardiac catheterization. It turned out they were wrong;
Janice was instead suffering from severe exhaustion, most likely from the
combination of work and caring for her mother. Still, she was pleased to have
gotten such attentive medical care—particularly since, as with all her other
medical needs, the insurance had covered it completely. Or, at
least, that’s what the insurance was supposed to do. Seven months later, as
she remembers it, a letter arrived announcing several thousand dollars in
unpaid charges. Janice called the hospital; when the staff there told her the
bill hadn’t been paid, she told them to resubmit it. “I have hospitalization
coverage,” she told them. “This must be a mistake.” When the hospital
contacted her again, explaining that it still hadn’t been paid, Janice
decided to call American Benefit. There, a clerk told her that the company
was simply reviewing the claim before paying it. That sounded reasonable
enough—insurers did that all the time, she knew—so she didn’t press the
matter. But
American Benefit didn’t pay. And when the hospital stopped sending bills and
started dispatching collection agents, Janice decided she needed to bring in
the authorities. She called the Florida Department of Insurance, hoping she
could persuade it to compel American Benefit to pay up. And that’s when a
state official broke the bad news to her. American Benefit was not even
licensed to sell health insurance in the state of Janice
would later learn that she had plenty of company. In a period of roughly two
years, thousands of people across the country had bought phony coverage from
con artists running similar operations. State officials eventually succeeded
in shutting down these scams. They even put some of the perpetrators in jail.
But they were less successful at recovering the victims’ premiums—money the
victims desperately needed because they now owed, collectively, millions in
unpaid bills to doctors, hospitals, and other health care providers. It was not
the first time this had happened. On the contrary, this was the third wave of
similarly designed health insurance scams to hit the It was a
problem inherent in the nature of private insurance, which had evolved around
the needs of large employers. But it was also a problem that had gotten
conspicuously worse in the last twenty-five to thirty years, leaving scam
victims like Janice Ramsey in a bind: up to their ears in medical debt and
without the insurance to pay new bills. People like Janice had enrolled with
American Benefit because they believed it would save them from mounting
medical bills. Instead, it made their problems worse. For anyone who
has been frustrated by the health care system, there will be a sense of
empathy for the many people whose stories are told on these pages. Long on
anecdote and short on analysis and solutions, Sick
beats the drumbeat that the system is broken, and may well be preaching to
the choir. The many reasons for change are chronicled throughout this book,
and many readers will close the last page more convinced than ever that this
system needs to change. Steve Hopkins,
May 25, 2007 |
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The recommendation rating for
this book appeared in the June 2007
issue of Executive Times URL for this review: http://www.hopkinsandcompany.com/Books/Sick.htm For Reprint Permission,
Contact: Hopkins & Company, LLC • E-mail: books@hopkinsandcompany.com |
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