I picked up this book because I'd read she talks a lot about the cost of her husband's medical care and the health care industry, which she sort of does.
Honestly, my reoccurring thought while I read this was that I would kill for their insurance. I know it was 2007 and pretty much everyone's insurance is crappier now. But still, she repeatedly mentions that her cost for expensive things was zero. I assume she had a small deductible that they went through but I don't know what it was because it's never mentioned. Nor is a 20/80 split (after the deductible) mentioned. I suppose it's a look at a family who literally never has to think about whether a treatment is affordable.
The problem is that I'm not really sure how instructive it is. Important things, like insurance markdowns,are mentioned but not really explored in depth. Personally, I think for the vast majority of people the benefit of health insurance isn't so much what an insurance company actually pays to a health care provider, (particularly as a deductible for a single person moves north of $1,000.00 per year) it's in reduced rate they're able to negotiate. Very few people pay the actual list price of a procedure. People who have insurance pay a lower amount that's been negotiated by the insurance company. People without insurance with low income likely have some or all of the cost written off through charity care.
She has a paragraph that lists the different costs of various procedures under different plans and in different locations, but maddeningly, she doesn't pursue why this might be. In at least one case a procedure ranged from around $400.00 under one plan/location and $1,200.00 under another plan/location. The higher number was later in time so it wasn't that the procedure's cost fell over time.
She wonders if they would have pursued all the treatments if they'd known the cost. I assume so. People go into medical bankruptcy all the time. I think where you see cost being an issue is people who have no insurance or who worry about co-pays or the deductible who put off getting something checked out or treated until they can't put it off and by then the treatment (if treatment is even possible) is much more expensive.
I also wish she had talked a little more about how acknowledging a patient is dying can be difficult for doctors too
It's entirely possible I'm being unfair wishing there were more depth on the health care side of things. If I'd come at it as a memoir rather than a book about the health care system maybe I wouldn't have noticed the omissions.
The memoir part is okay. I suppose I just don't see the appeal of being with someone with whom I fight all the time. There is clear affection there, though. And it was interesting reading a bit about China in the early 1980s.