Customer Reviews: Sick: The Untold Story of America's Health Care Crisis---and the People Who Pay the Price
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on April 12, 2007
The fact of the matter is that the US is the ONLY industrialized nation to treat healthcare as a purchased privelege, rather than a basic human right. The "Healthcare" system in the US is broken, and the truth is that millions men, women, and children are unable to access basic healthcare for the simple reason that they are poor. Furthermore, millions of WORKING americans do not have adequate healthcare coverage. But whether someone is working or not, if you believe that all humans have dignity and therefore entitled to basic human rights, then you must conclude that all americans deserve a quality of life that ensures basic healthcare. Marginalized populations, especially minorities, suffer disproportionately from the effects of being uninsured and the consequences of lack of healthcare. This is an issue of SOCIAL JUSTICE.

I doubt that anyone arguing against universalized healthcare is actually unisured. Only those who have the means to benefit from US healthcare voice their opinions against universal coverage.

Americans have some of the best doctors and healthcare in the world, IF you can access care. Furthermore, as Americans we have POORER health outcomes and spend MORE money overall on our healthcare system than other industrialized nations like Japan, Germany, France --nations that HAVE universal health coverage.

The privitized system of healthcare delivery has been an 80 yr. experiment that has FAILED miserably. It is time to consider other options.

Cohn has researched this issue for years, and this book presents the evidence as it is.
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on April 10, 2011
"Sick" is a book that will get you all fired up, if you are a supporter of health care reform. If you are not a supporter, you will probably not choose to read the book, which gives a good overview of most of the major reasons for the need for health care reform in the U.S. At the end of the book, the author makes a convincing argument for universal health care in the U.S.

Perhaps the biggest attribute of the book is the storytelling. In several chapters, the reader is told the history of the person, couple or family, before we learn about their problems with health care accessibility and/or affordability. He really sets us up to feel the pain experienced: financial and/or mental. The stories are heartbreaking. In most cases, if not all, these "victims" simply do not see their problems coming.

Their stories should get you fired up. Most chapters centers one individual or family and on one area of health care, including emergency rooms, the loss of employer-provided health insurance, disabled children, individual policy issues and scams, Medicaid issues with for-profit hospitals, indigent coverage, lack of preventative care for the poor, and mental illness.

But we are also given the big picture, as well:
* Most Americans HAVE health insurance (coverage that is highly subsidized by their employer or by government).
* Only about 16% of American residents, about 50 million, are without health insurance.
* Those with health care insurance have a hard time relating to those who do not.
* Most think that the uninsured are also unemployed.
* Most think that those uninsured can get medical attention when they need it.
* Ever since modern health insurance emerged in the 1920's, it has had a hard time covering everyone.
* At any one time, only a small percentage of people will have a serious health problem.
* Employers are increasingly reluctant to subsidize employees for health care insurance.
* Hospitals try to keep their numbers of uninsured at a minimum.

The author attacks the myth that, in America, we have the best health care system in the world. No other country, for example, comes close to spending 16% of its GNP on health care, as we do. Still, rates for infant mortality and life expectance are about average for the U.S., in comparison with other developed countries. And, stories about the faults of nationalized health care in other developed countries are often exaggerated, if they are true at all. For example, per the author, "Waiting lists and lines, the supposed drawbacks of universal health care (in other countries with nationalized health care), appear to be nonexistent."

The copyright on the paperback I read is 2007, which is well before the enactment of The Affordable Care Act of 2010, so there is no telling how happy the author is now in relationship to the stories told in his book. In praising health care in France, he says, "The French health care system isn't perfect. No system is." But he goes on to praise the French system because its "financial barriers to care are virtually nonexistent." In contrast, he finds the American system to "ration by income and by medical condition." And he expresses his fear that the American health care system "is reverting to what it looked like before modern insurance existed."

I think that "Sick" is a very good read. I recommend it highly.
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on December 7, 2008
Jonathan Cohn has touched the heart of America in Sick by highlighting our dysfunctional healthcare system in a personal way. Stories of everyday Americans and their medical tragedies have woven that personal touch with the history of our healthcare system. He presents the account of health issues with both data and his own opinion in a way that targets the general population and holds the government accountable. Cohn discusses the financial devastation related to medical debt that was not uncommon by the late 1990s. Research conducted by Professor Elizabeth Warren of Harvard Law School found that "medical debt had become a leading cause of bankruptcy in America" (p. 21).
Personal stories lead into the current health care issues such as over crowding in emergency rooms leading to poor patient outcomes, managed care that restricts where and who members can receive treatment from, employer linked healthcare and the financial burden to the employer, and pre-existing conditions which severely restricts obtaining insurance. He reviews history of the inception and implementation of Medicare, Medicaid, the Health Insurance Portability and Accountability Act, State Children's Health Insurance Program, Health Maintenance Organizations, Medicare + Choice, the Medicare Modernization Act, and mental health parity laws. As a nation, we have come a long way since the early twentieth century when "the idea of using insurance to help people deal with illness started to get serious attention"(p. 5). Americans have been ambivalent regarding healthcare changes because the majority of Americans have insurance that works for them but it is not until it is too late that they realize it is insufficient.
Recommendations for this book would include anyone who seeks further information on our healthcare system and those in a position to make changes. A rating of four stars is given for Cohn's writing style which makes this an interesting read and brings the reader to an understanding of our current healthcare system. Cohn's conclusion supporting universal healthcare is correct, "Universal healthcare is really about finding collective strength in our individual vulnerabilities" (p. 231). The future of healthcare is now rests in the hands of the Obama team.
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on November 26, 2014
Readers should have a box of tissues handy when you encounter the hardships and heart breaks our broken medical care system has caused. The pain and suffering to the families is almost as bad as that encountered by the patients themselves.
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VINE VOICEon February 26, 2008
The health care industry is doing an extremely poor job of serving Americans. As the author points out, "No other country in the world comes even close to spending 16 percent if its wealth on medical care" and I would add that no country gets so little bang for their buck. So what's the problem? The author points to a few glaring deficiencies perhaps the biggest being that our health care system has little to no incentive to prevent illnesses. Unlike just about every other first world country the U.S. health care system is designed as a money making institution and chronic health problems are the bread and butter of the profit structure.

HMO's removed the incentive to run up big bills but doctor's performances were now being judged on their ability to cut costs and patient's health remained a low priority. The author writes, "If the old hands-off approach to paying medical claims favored overtreatment, the new one seemed biased towards undertreatment" with a significant portion of profits going towards executive salaries. The author mentions Leonard Abramson who sold U.S. Healthcare to Aetna in 1996 and walked away with a $500 million payout. Imagine how much health care was denied so Abramson could get his huge payday. It's not just the cost of executives it's the cost of advertisement and administration. The fact of the matter is the capitalism has failed miserably as the engine of health care because there has never been an effective link between a healthy society and high profits.

Conservatives believe that "the fundamental problem with American health care today is that people have too much insurance." Excessive insurance might encourage people to be reckless with their health and overuse health services. However, the reality is a lack of health insurance is forcing millions of American's to skip regular checkups or wait until problems have reached a critical level before seeking medical help. This creates huge expenses down the line treating preventable medical conditions. The United States has been run by ideologues who are so "convinced of the private sector's inherent efficiency that [they are] willing to waste billions of taxpayer dollars to prove it" With regards to Bush's Medicare reform package the author writes, "at the behest of those who never really believed in the program, it had expanded in a way that undermined its effectiveness - and jeopardized its long-term survival"

My biggest problem with Sick was that it focused almost exclusively on anecdotes. Sad stories (and they are sad) may tug at the heart strings but it's empirical evidence that reveals the truth. I was more interested in facts, for instance the author mentions that roughly $1 in $10 flowing through the U.S. medical system is used to treat diabetes, a generally preventable disease. What this tells me is that there is a lot of blame to go around and some of it rests squarely on the shoulders of American's who don't do enough to avoid preventable medical problems but this also leads back to the problem with the health care industry having no emphasis on prevention.

Universal healthcare is the author's recommended solution. The strength of the United States lies in our ability to marshal the power of over 300 million people but the conservative/libertarian view is that forcing anyone, particularly healthy young people to pay for health insurance is counter to the conservative view of freedom. However, unless everyone participates universal health care is doomed from the start. Those same healthy people who pay for more than they get will one day get more than they pay. We pay in more when we're healthy and draw more when we are sick. The federal government is the only institution that can manage healthcare requiring full participation. Sick is a good book but I wish the author had added more data and less stories to back up his arguments.
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on April 4, 2008
Cohn's book for all of its less than 250 pages gives a thoughtful analysis of the complicated web known as health care insurance. Good history of insurance in the 20th century, so this is more than just current events. Does point out the inherent benefits and flaws in the way Medicare and Medicaid was set up, as well as how regulation or lack thereof came about. Note that this is not a comprehensive book on health care economics.
Most of the book is taken up by stories indicating various issues with the health care system by using specific patient histories. It gets a bit sentimental at times, but they are good examples. The solutions section at the end is about 30 pages, a little short on specifics.
If you have a very conservative economic bent, are convinced that we should go back to a system with complete lack of insurance for those unable to pay, that somehow the free market is going to cure the system, this is not the book for you. Anyone else, this is not a comprehensive text, but a nice, nonstatistical volume, a place to start.
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on August 8, 2007
This book just begins to describe the issues with our health care system. The for-profits skim the lucrative services from the "not-for-profits", leaving us all with the tab. We are all subsidizing the for profit entities and paying their dividends.
Do people really think the US Government does not control the US healthcare system now? Medicare and Medicaid represent over half of hospital and physician payments and everything else is heavily regulated by the US government now! We have a government run and controlled system now and it is operating poorly!
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on August 29, 2014
Book is okay! Very, very one sided. You have to read the book with an open mind. I have issues with people who blame the Government for everything. Some of these people didn't take advantage of "free" services until way too late. I did enjoy reading the book and my heart did hurt for most of the families in the book.
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on August 16, 2007
I needed to read this book for a class I was taking. But, it was not a chore to read at all. It was very informative and gave me answers to questions I had regarding the health care situation here in the United States. The book is very easy to read and I could hardly put it down. I would recommend this book to anyone who wants to know more about the health care crisis.
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on October 14, 2007
This book is a great read, that yet again, puts a much needed human face on our health care crisis.
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