UNHEALTHY SYSTEM
'Sick'
Cohn writes of problems, confusion people face in dealing with health
care in U.S.
Reyhan Harmanci
Thursday, April 19, 2007
New Republic magazine editor Jonathan Cohn is pleased with his own health
insurance situation (his wife is a professor at the University of Michigan,
and he enjoys the benefits of the university's health plan), but he says
he knows he shares the same risks as any American.
"It's amazing the way things can be going along, and then, boom,
one bad thing happens and your life unravels," Cohn says in a phone
interview. "I don't think the public appreciates how vulnerable they
are."
Cohn, who has covered health insurance for the New Republic since the
'90s, has written a book that explores the human cost of a convoluted,
confusing and mismanaged system. "Sick: The Untold Story of America's
Health Care Crisis -- and the People Who Pay the Price" unwraps the
problems in U.S. health care by looking at people and their families.
Cohn found people who would be indicative of some of the larger issues.
Doing the book this way is a reversal of the typical process, where personal
narrative shapes the bigger conclusions. The advantage of this, Cohn says,
is that the book's organization is clear at the start. "The downside
is that you don't start with this ready-made base of contacts."
Cohn found stories by visiting clinics, talking to advocacy groups and
hitting the streets. He printed up bilingual flyers, for instance, when
he went to Los Angeles and handed them out at street corners.
What he learned, on some issues, contradicted his initial assumptions.
On Medicaid, he found that one of the biggest problems wasn't the benefit
package, which is more than adequate in many states, but rather eligibility.
"It turns out that it's incredibly difficult to stay on Medicaid
by design. A lot of states try to make it difficult, partially to weed
out fraud, but also just to stay on the lists and get the benefits."
The biggest surprise for him was the number of middle-class people with
jobs who suffer under the current system. "When I started, this was
a book about managed care," he says. "But pretty quickly it
became apparent that the real problems were the un- and underinsured."
Cohn is sanguine about the chances Americans will embrace universal health
care. On one hand, he says, polls point to acceptance of taxation to pay
for a government-backed system. On the other hand, American politicians
have been proposing reforms for many years. "I'm watching California
very closely," he says. "Back in the late Progressive era (the
first part of the 20th century), California was one of two states that
almost passed universal health care."
Jonathan Cohn reads at 7 p.m. today. Free. Cody’s, 1730 Fourth
St., Berkeley. (510) 559-9500. www.codysbooks.com.
Reyhan Harmanci, rharmanci@96hours.com
http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/04/19/NSGRJN8SQE1.DTL
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