A searing and sobering indictment of the public health care system that highlights the inequality of treatment.
In the spirit of investigative journalism, this assessment of public hospitals paints a grim picture of health care for the poor in America.
Debut author King, a former newspaper reporter, focuses primarily on Atlanta’s Grady Memorial Hospital, showing that the public hospital in general has become “the symbol of how the poor are cared for in the United States.” This book traces Grady’s history and compares it to the evolution of four other public hospitals, demonstrating the challenges such centers face in serving their communities. Grady’s story is deftly interwoven with the advents of Medicare and Medicaid and, more recently, the Affordable Care Act. Perhaps most disturbing is King’s insightful exploration of the intersection of race, poverty, and health care, particularly in the South. Grady, for example, which started as “White Grady” and “Black Grady,” was desegregated after the 1964 Civil Rights Act; still, “remnants of Grady’s segregated past lingered for years.” The larger issue, however, was Grady’s compensation for taking impoverished patients. Grady’s Emergency Room, like those of other public hospitals, couldn’t turn away patients with life-threatening ailments. King notes, however, that nonprofit and private hospitals routinely “send patients without life-threatening conditions who come to their ERs to a public hospital for what they deem to be nonemergency care.” Public hospitals typically receive payment for these poor patients via Medicaid—but in the South, “state Medicaid programs have been unusually restrictive.” In fact, the author reports, “by refusing to expand Medicaid, Georgia was leaving about $9 million a day on the table, unclaimed for use by the neediest people in the state and the hospitals that treat them.” Grady survived, writes King, because of the efforts of local business leaders rather than county or state governments. In this important book, the author more briefly recounts similar stories of the other four public hospitals: Parkland Memorial Hospital in Dallas, Jackson Memorial Hospital in Miami, the John H. Stroger Hospital of Cook County in Chicago, and Charity Hospital in New Orleans. Carefully documented, journalistically crafted, and artfully told, this account illuminates the myriad struggles of public hospitals to effectively treat the indigent. King bluntly asks: “Have we reached the point where public officials, particularly those in the South, are frozen in the ice of their own indifference when it comes to the government’s responsibility in caring for the poor?”
A searing and sobering indictment of the public health care system that highlights the inequality of treatment.Pub Date: May 31, 2016
ISBN: 978-1-944962-06-7
Page Count: 352
Publisher: Secant Publishing
Review Posted Online: May 4, 2016
Kirkus Reviews Issue: June 15, 2016
Review Program: Kirkus Indie
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 moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular...
A neurosurgeon with a passion for literature tragically finds his perfect subject after his diagnosis of terminal lung cancer.
Writing isn’t brain surgery, but it’s rare when someone adept at the latter is also so accomplished at the former. Searching for meaning and purpose in his life, Kalanithi pursued a doctorate in literature and had felt certain that he wouldn’t enter the field of medicine, in which his father and other members of his family excelled. “But I couldn’t let go of the question,” he writes, after realizing that his goals “didn’t quite fit in an English department.” “Where did biology, morality, literature and philosophy intersect?” So he decided to set aside his doctoral dissertation and belatedly prepare for medical school, which “would allow me a chance to find answers that are not in books, to find a different sort of sublime, to forge relationships with the suffering, and to keep following the question of what makes human life meaningful, even in the face of death and decay.” The author’s empathy undoubtedly made him an exceptional doctor, and the precision of his prose—as well as the moral purpose underscoring it—suggests that he could have written a good book on any subject he chose. Part of what makes this book so essential is the fact that it was written under a death sentence following the diagnosis that upended his life, just as he was preparing to end his residency and attract offers at the top of his profession. Kalanithi learned he might have 10 years to live or perhaps five. Should he return to neurosurgery (he could and did), or should he write (he also did)? Should he and his wife have a baby? They did, eight months before he died, which was less than two years after the original diagnosis. “The fact of death is unsettling,” he understates. “Yet there is no other way to live.”
A moving meditation on mortality by a gifted writer whose dual perspectives of physician and patient provide a singular clarity.Pub Date: Jan. 19, 2016
ISBN: 978-0-8129-8840-6
Page Count: 248
Publisher: Random House
Review Posted Online: Sept. 29, 2015
Kirkus Reviews Issue: Oct. 15, 2015
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