Spenser first encountered this in 2015, when emergency room services at Excel Pinnacle Hospital were contracted out to Benevolent Holdings. (He changes proper nouns throughout the book, often with a satiric spirit.) Now doctors felt pressure to admit more E.R. patients to the hospital proper, “especially if the patients admitted had good insurance and could pay their hospital bills.” Meanwhile, under new rules crafted to keep physicians efficient, quality of care declined, with the powers that be mostly neglecting to address complaints. Soon other departments went the way of the emergency room, with crucial staff let go, longstanding contracts canceled, and patients literally dying without seeing doctors.
While this compact page-turner doesn’t name names, it still reveals harrowing cases, systemic failures, and the Orwellian corporate doublespeak that greeted his and others’ efforts to enact change. Especially chilling is Spenser’s account of going to “war” with the Merciful Insurance Company, which, he reports, would eventually attempt to “bully my pathology lab into insolvency.” He illuminates the complexities of billing, insurance, and government programs that companies are incentivized to exploit—and he always emphasizes the devastating impact this has on the individual and collective health of Americans.
Takeaway: The harrowing story of medical professionals facing corporate power that puts patients last.
Great for fans of: Elisabeth Rosenthal’s An American Sickness, Jonathan Bush’s Where Does it Hurt?
Production grades
Cover: A-
Design and typography: A
Illustrations: N/A
Editing: A
Marketing copy: A
