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 valuable: 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.

CUSTOMER REVIEWS (Average Customer Rating: 3.5 based on 18 reviews)

I'm sick of it

Everyone has an opinion. I've been a family practice physician now for 30 years, and see the situation from the patient, hospital and personal viewpoint. The best, most honest and straight forward written information I've seen comes from William C. Waters III, MD. The small book, or pamphlet, called "2 days that ruined your health care", came from AAPS. I ordered 30 more copies, and my hospital administrator ordered 100, to give to board members and interested others. Unfortunately, I'm afraid there is irresistible political pressure insure more of the same.
November 27, 2008

Long on Analysis, short on solutions

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.
April 05, 2008

The System Just Isn't Working

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.
February 26, 2008

A compelling read

This book is a great read, that yet again, puts a much needed human face on our health care crisis.
October 14, 2007

Good reading

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.
August 16, 2007

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How Doctors Think
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Who Killed Health Care?: America's $2 Trillion Medical Problem - and the Consumer-Driven Cure
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Better: A Surgeon's Notes on Performance
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Overtreated: Why Too Much Medicine Is Making Us Sicker and Poorer
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