Small Ohio town is focus of book that looks at our ongoing health care crisis
“The Hospital - Life, Death, and Dollars in a Small American Town” by Brian Alexander (St. Martin’s Press, 307 pages, $28.99)
The investigative journalist Brian Alexander just published “The Hospital - Life, Death, and Dollars in a Small American Town.” He was granted an amazing degree of access to the inner workings of the Community Hospitals and Wellness Centers, in Bryan, Ohio. and this made it possible for him to witness the recent operations of this institution located in the northeast corner of our state.
His “fly on the wall” vantage point allowed him to eavesdrop on contentious hospital board meetings, to witness life and death dramas in the emergency room, and to arrive at harrowing highway accident scenes. All this was made possible because the CEO of the hospital granted him permission to do so without placing any restrictions whatsoever on what he chose to write about it.
As Alexander studied the hospital’s inner workings he found a situation that is apparently not uncommon among small independent community hospitals, the institution was consistently failing to break even. As the deficits accumulated with each passing month the administration was under intense pressure to turn things around.
Their CEO was a bit of a maverick. He was willing to take risks. Perhaps that explains why he even considered allowing this writer to peer behind the curtain, to reveal information that some board members would have probably preferred to keep private. This reviewer got the sense that some of the rancor being expressed in those meetings could have been due in some small part, to disgruntlement about the author’s presence.
The most potent passages in “The Hospital” take place some distance from that institution. Alexander got to know some ordinary citizens. He befriended one in particular, a young man named Keith. He details how Keith was drawn into an unrelenting health care nightmare. Keith just wanted a family and a steady job. His struggles seem emblematic of what many Americans are facing every day.
If there is one takeaway in this book it could be this; our health care system is a complete mess, in fact even calling it a system seems almost absurd because it is so unreliable, chaotic, and appallingly Byzantine. Alexander writes: “The idea that doctors could or would steer patients to low-cost hospitals or to high-quality ones was laughable.”
He continues: “Doctors had no idea what hospitals, even hospitals where they worked, charged for services, and neither did most other people. Hospitals and insurers kept their pricing and their insurance contract negotiations confidential. So a broken leg for one patient could wind up costing much more, or much less, than the exact same break would cost someone else.”
Small community hospitals like the one in Bryan are under perpetual pressure to remain independent. Large hospital groups are frequently circling, waiting for these treasured local entities to finally surrender to market forces and allow themselves to be absorbed into these massive hospital consortiums. Alexander shows how some huge hospital groups are highly attractive to investors because these ostensibly non-profit organizations can still generate massive profits under our current health care system, such as it is.