A deeply insightful and disheartening portrait of America’s diseased health care system.
A superb account of a small-town hospital whose first priority is delivering high-quality medical care. Sadly, in today’s brutally competitive free market, that means it’s barely surviving.
In this eye-opening investigative study, journalist Alexander takes us to Bryan, Ohio, which has mostly recovered from the 2008 recession and possesses a surprisingly good hospital for its size (pop. 8,000). The author offers vivid portraits of a dozen individuals, including the hospital’s CEO, Phil Ennen, and readers will receive an expert education in his duties. Delivering care is one, but the business side is difficult. If rival medical centers steal business, customers don’t pay, or income doesn’t match expenses, his hospital will fail. Small hospitals have two strikes against them: Suppliers charge them more, and insurance companies pay them less (big medical systems negotiate for higher reimbursement; small ones have no clout). The free market extols efficiency above all. Once part of a larger system, Bryan’s hospital would see its staff trimmed, unprofitable services eliminated, and specialists moved to bigger cities. With less to offer, the hospital would become a drag on larger facilities; if it continued down that path, it would eventually close, a process that is playing out across the U.S. As of 2020, the hospital is hanging on and may even survive the pandemic, which is proving equally disastrous to rival hospitals. However, the future looks grim. Like all hospitals, Bryan’s depends heavily on government money, especially Medicare and Medicaid, but it’s not adequate, and this is unlikely to change in the near future. Like many states, Ohio has been cutting taxes and social services since the Reagan years, producing stagnant wages and declining health but only scattered calls for reform—certainly not in Bryan, where “a local politician could blame problems associated with a…business on the fact the owner was ‘not of American extraction’ and know he wouldn’t hear any disapproval.”
A deeply insightful and disheartening portrait of America’s diseased health care system.Pub Date: March 9, 2021
ISBN: 978-1-250-23735-4
Page Count: 320
Publisher: St. Martin's
Review Posted Online: Nov. 23, 2020
Kirkus Reviews Issue: Dec. 15, 2020
For Howard Zinn, long-time civil rights and anti-war activist, history and ideology have a lot in common. Since he thinks that everything is in someone's interest, the historian—Zinn posits—has to figure out whose interests he or she is defining/defending/reconstructing (hence one of his previous books, The Politics of History). Zinn has no doubts about where he stands in this "people's history": "it is a history disrespectful of governments and respectful of people's movements of resistance." So what we get here, instead of the usual survey of wars, presidents, and institutions, is a survey of the usual rebellions, strikes, and protest movements. Zinn starts out by depicting the arrival of Columbus in North America from the standpoint of the Indians (which amounts to their standpoint as constructed from the observations of the Europeans); and, after easily establishing the cultural disharmony that ensued, he goes on to the importation of slaves into the colonies. Add the laborers and indentured servants that followed, plus women and later immigrants, and you have Zinn's amorphous constituency. To hear Zinn tell it, all anyone did in America at any time was to oppress or be oppressed; and so he obscures as much as his hated mainstream historical foes do—only in Zinn's case there is that absurd presumption that virtually everything that came to pass was the work of ruling-class planning: this amounts to one great indictment for conspiracy. Despite surface similarities, this is not a social history, since we get no sense of the fabric of life. Instead of negating the one-sided histories he detests, Zinn has merely reversed the image; the distortion remains.
Pub Date: Jan. 1, 1979
ISBN: 0061965588
Page Count: 772
Publisher: Harper & Row
Review Posted Online: May 26, 2012
Kirkus Reviews Issue: Jan. 1, 1979
BOOK REVIEW
BOOK REVIEW
BOOK REVIEW
A fierce, penetrating, and empowering call for change.
Artist and activist Vaid-Menon demonstrates how the normativity of the gender binary represses creativity and inflicts physical and emotional violence.
The author, whose parents emigrated from India, writes about how enforcement of the gender binary begins before birth and affects people in all stages of life, with people of color being especially vulnerable due to Western conceptions of gender as binary. Gender assignments create a narrative for how a person should behave, what they are allowed to like or wear, and how they express themself. Punishment of nonconformity leads to an inseparable link between gender and shame. Vaid-Menon challenges familiar arguments against gender nonconformity, breaking them down into four categories—dismissal, inconvenience, biology, and the slippery slope (fear of the consequences of acceptance). Headers in bold font create an accessible navigation experience from one analysis to the next. The prose maintains a conversational tone that feels as intimate and vulnerable as talking with a best friend. At the same time, the author's turns of phrase in moments of deep insight ring with precision and poetry. In one reflection, they write, “the most lethal part of the human body is not the fist; it is the eye. What people see and how people see it has everything to do with power.” While this short essay speaks honestly of pain and injustice, it concludes with encouragement and an invitation into a future that celebrates transformation.
A fierce, penetrating, and empowering call for change. (writing prompt) (Nonfiction. 14-adult)Pub Date: June 2, 2020
ISBN: 978-0-593-09465-5
Page Count: 64
Publisher: Penguin Workshop
Review Posted Online: March 14, 2020
Kirkus Reviews Issue: April 1, 2020
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