So Much for That by Lionel Shriver

Shep Knacker is a nice guy trying to live his dream of heading off to a simpler life in Pemba in Africa. He has sold his business and his home and has been researching possible locations for years. Finally he is about to bite the bullet … and his wife gets cancer. So begins Lionel Shriver’s searing analysis of the American health system, albeit in the guise of a novel. This book took some reading because there were times when, like the characters, I almost felt I couldn’t go on. But it was compelling at the same time, especially the secondary story of Shep’s mate Jackson whose daughter has a rare genetic disorder that is slowly killing her. There’s no escape for these people, and by inference anyone else in the US, where the system exists to serve the profit driven operations of the insurance companies and where employees are stuck in jobs because they need the otherwise unaffordable health insurance that comes along with the gig. The lack of government assistance is chilling. People who don’t have insurance, or whose money runs out because of the incredible 40% co-payments required, are faced with on-the-streets option, something almost unthinkable for an Australian with such a wonderful health care system and a safety net to boot. Shriver has done her usual careful research: the detailed descriptions of the system, the diseases and their effects on people’s lives ring utterly true and are extremely discomfiting. The only thing I didn’t like about this book was the ending, which I simply didn’t buy.