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Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price Paperback – May 6, 2008

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Editorial Reviews

From Publishers Weekly

In this addition to the growing list of exposés of the toll our patchwork, profit-based health-care system takes on Americans, Cohn makes a plea for a universal coverage with a single-payer system regulated by the government. Drawing on research and riveting anecdotes, Cohn, a senior editor at the New Republic, describes how private insurers decide who and what they will—and will not—cover. He also examines how rising health-care costs lead corporations to seek ways to deny coverage to employees, such as hiring full-time workers as temps or independent contractors without health insurance. In tale after tale, Cohn documents the sometimes catastrophic results. they couldn't. Cohn points out that managed care initially had an altruistic goal of making health-care affordable for all. But by 1997, two-thirds of HMOs were controlled by for-profit companies concerned with making money rather than preventing and easing sickness. The author convincingly argues that Medicare and universal health care in such countries as France, though not perfect, are far superior to the system most Americans face. Much of this is well-trod territory, but Cohn is eloquent, and he's good at using case studies to dramatize and explain complex issues. (Apr. 10)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved. --This text refers to an out of print or unavailable edition of this title.

From Booklist

Overcrowded emergency rooms force ambulances to drive patients to more distant hospitals; the uninsured crowd emergency rooms for nonemergency health care, adding to the problem as hospitals and patients struggle to balance supply and demand, and profitability. New Republic reporter Cohn offers personal stories of families--and the nation--suffering health-care crises. A man who has lost his health insurance watches his wife die of cancer that might have been detected earlier if he'd had better coverage, a Texas woman fights with her insurer to get her disabled baby therapy that could help him learn to walk. Cohn presents case after case of Americans bereft of adequate health care coverage after losing their jobs, or seeing their employers cut back on coverage, or insurers fight to provide the minimum of coverage. Cohn uses each case study to provide a historical and modern perspective on insurance and health care delivery, and the factors that have led to the current crisis. Vanessa Bush
Copyright © American Library Association. All rights reserved --This text refers to an out of print or unavailable edition of this title.
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Product Details

  • Paperback: 316 pages
  • Publisher: Harper Perennial; 1 Reprint edition (May 6, 2008)
  • Language: English
  • ISBN-10: 0060580461
  • ISBN-13: 978-0060580469
  • Product Dimensions: 5.3 x 0.8 x 8 inches
  • Shipping Weight: 8.8 ounces (View shipping rates and policies)
  • Average Customer Review: 3.9 out of 5 stars  See all reviews (37 customer reviews)
  • Amazon Best Sellers Rank: #351,267 in Books (See Top 100 in Books)

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Most Helpful Customer Reviews

48 of 50 people found the following review helpful By Stephen R. Laniel on June 30, 2007
Format: Hardcover
I can't recommend this book highly enough. At first glance, one might expect its structure to be gimmicky:

1. Interview someone who suffered because of our country's health-insurance system.
2. Zoom out from that person to explain the political and economic background to his or her suffering.
3. Zoom back in.
4. Repeat 2) and 3) a few times.
5. Move on to the next person and repeat from step 1).

Far from being a gimmick, I couldn't imagine a better narrative device. Jonathan Cohn combines the passion of a muckraking journalist with the erudition of a historian. His delivery is simple, unpretentious, and never cloying.

His conclusion is simple: health insurance as delivered by private companies doesn't work, because their incentive is always to cut services to the bone; the ideal hospital for an insurer is one that has no patients. The history of health insurance, as Cohn tells it, is the history of nonprofit corporations and idealistic doctors slowly getting replaced by for-profit corporations that destroyed the industry they were ostensibly meant to save.

Of course there's a way out; it's the way that every other industrialized nation uses, namely guaranteeing citizens the right to health care as a basic condition of citizenship. They spend far less than 16% of their GDP on health care, which is where the U.S. is today. The main obstacle to universal health care in this country is political. We overcame that obstacle in the Sixties and got Medicare and Medicaid; in Cohn's telling, they are models of efficient health-care delivery. (He says that surveys of the elderly, who are covered by these programs, find that they're more satisfied with their coverage than are young people in private insurance programs.) It will take a political change to bring us universal health care, but we've come close before. There's no reason we couldn't do it again.
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29 of 30 people found the following review helpful By Izaak VanGaalen on May 22, 2007
Format: Hardcover Verified Purchase
Why this book is subtitled "The Untold Story of America's Health Care Crisis - And the People Who Pay the Price" is beyond me. Everyone has a story about the failure of our health care system or "non-system" and everyone is paying the price. Not only is it becoming more obvious by the day, almost every presidential contender is promising some kind of reform.

Jonathan Cohn of The New Republic has given us a number of revealing and disturbing case studies, each indicating system failure; and with each study he gives us some historical background as to how certain institutions - Medicare, Medicaid, managed care, employer-based health insurance, etc. - came to be. The historical background is good because is shows that there was no single policy or grand design behind our current mess; it is more a product of haphazard decisions made over a long period of time.

Let's look at some facts. America spends about $7,000 per capita on health care annually, about twice as much as the country in second place. Yet we are ranked 37th in health system performance, according to WHO. There is indisputably something very wrong.

Our system can best be described as a private, employer-based health insurance system. It started during World War II with the wartime freeze on wages. Companies started offering health insurance to attract and keep employees. And the rest, as they say, is history. Today we have Daimler basically giving away Chrysler because they have about $18 billion worth of health care liabilities. Every single worker is paying for about three retirees - and their families. Now, the only way Chrysler can keep employees is if they drastically reduce their health benefits.

So what's the author's solution?
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21 of 23 people found the following review helpful By Robin Orlowski on May 27, 2007
Format: Hardcover
Arguing that current American health care coverage policies continue growing woefully inadequate, Cohn's book relies on 'hard' statistics culled from the government and private sector itself. Layoffs, cumbersome 'pre-existing' condition rules and a conglomerate of other socioeconomic factors undermined America's ability to enjoy good quality of life.

He also includes sobering stories from and by people whose lives are damaged by lack of (adequate) health care insurance coverage. Their heart-wrenching stories, including from the family whose wife/mother ultimately succeeded in committing suicide just because she was unable to receive coverage and did not want to be a 'financial drain', contrasts starkly with the propaganda being put out by the multi-million dollar companies of smiling happy and secure Americans appearing to not care about much other than romping in fields. Seeing myself reflected in these testimonies, I found the book's 'personal touch' a powerful component because it defuses the lobby's ongoing contention that any healthcare reform would hurt 'ordinary Americans', when obviously it is the insurance industry themselves responsible for our current agony.

So, where are the flaws in this book if it starts out so strongly and advances a topic which is ever-more timely for so many Americans? For how passionately he argues against the current model, Cohn can't seem to provide detailed specifics on just what would be offer up Americans in comparison and how this alternative would work better than what currently exists. I came in on both the personal and political level wanting to like this book, and still agree with it's overall thesis, but feel let down that the author stopped 'prescribing' change just when it was getting to the really good stuff.
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