I've just finished two terrific new books: High Wire: The Precarious Financial Lives of American Families by long-time LA Times reporter Peter Gosselin, and Hospital by Julie Salamon. In quite different ways, each illuminates some of the critical social policy issues of our time.
High Wire is both an anecdotal and deeply analytical look at why Americans feel so financially insecure these days. It goes far beyond the usual “are we better off” blather that infects political campaigns and instead takes a close look at the impact of both risk and income volatility on American families. The ownership society, once so highly touted by the Bush Administration, certainly gives people the opportunity to share in the rewards of a strong economy. But it also means they own more of the downside risk, not only of macroeconomic turmoil but also of personal catastrophe. And, unlike, say, Merrill Lynch, they don't have the means to hedge. No derivatives for them.
Gosselin, who is also a visiting fellow at The Urban Institute, looks at the impact of events such as job loss or major illness on incomes, and the results are not pretty. While the chances of getting hammered by one of these events are a bit lower than in the past, the consequences are more severe. Urban's Rich Johnson has looked at this question in another way and come to a similar conclusion.
Salamon's book is very different. Hospital, which carries the very cool subtitle Man, Woman, Birth, Death, Infinity, Plus Red Tape, Bad Behavior, Money, God and Diversity on Steroids is a beautifully written and closely observed look at life inside Maimonides Hospital in Brooklyn. Most of us know hospitals either from a patient's bedside or from overheated TV medi-dramas. Those of us who are health policy wonks may even know about DRGs. What Salamon does is show us, though the eyes of an extraordinary cast of characters, what living with this insane payment system means.
Salamon, a former staffer at both The New York Times and the Wall Street Journal, got extraordinary access to Maimonides—everywhere from the emergency department to the executive offices. And while some of what happened during her year there could have only happened in Brooklyn, much is all too typical of any hospital in the U.S. This isn't Grey's Anatomy. It is the real deal. If you want to know how a hospital really works, read this book.
