The Hospital

Well-written, extremely disturbing look at the modern healthcare industry primarily seen through the lens of a rural Ohio hospital that is struggling to keep from being gobbled up by one of the huge healthcare systems, and the mostly low-income patients who show up at its ER in crisis because they can't afford regular ongoing care. The thread through all of it is 21st century capitalism that thinks everything should run like a business, deplores anything that smacks of “socialized medicine,” and doesn't care that “full employment” means people working 3 part-time jobs with no health insurance, or at best insurance with very high deductibles. And the bottom line is that until we address persistent poverty and income inequality, we will never be able to address healthcare issues. Not a very rosy outlook, and then COVID came along and made everything worse.

As a social worker involved with mental health systems change, none of this is new information to me, but Alexander's ability to present historical background, healthcare policy, and stories of people doing their best but losing their health and their lives makes this book a compelling read for anyone who cares about our country's future. I had to look up Bryan's community hospital online to see if it remains independent in March 2021(it is) , but even if it is, the deck is stacked against it.