The Departure by Brian Alexander McCullough

The only sane conclusion is that America’s dysfunctional health care system needs holistic change, not just a Band-Aid.

A lifetime of cheap insulin might run $25,000 Keith’s multiple surgeries have cost significantly more. Even if you don’t care about him as a human, you should be horrified by what this costs all of us. The end result: Keith loses toes, limbs, and an eye. And he doesn’t skip his insulin out of indolence (OK, maybe a little) but because he can’t afford it. He’s been born into a era when all the decent-paying, working-man jobs have gone away, replaced by slots at Menards or Taco Bell, for wages meant to provide teenagers with gas money, not to pay rent and feed children. But Alexander makes clear that Keith is a man, no better or worse than most, who like many Americans has been dealt a bad hand from birth. Keith is the kind of American rarely written about in these kinds of books, because there’s no redemption arc: He eats crap, watches a lot of television, and lets his diabetes spin into chaos by not taking his insulin on a regular basis. One of Menards’ employees is Keith, an overweight diabetic with a recently dead wife and a child. Now in his fifties, he’s been at the hospital for almost his entire adult life, watching the town crater economically until CHWC is all that remains of its identity. Ennen is a charismatic and tempestuous executive who finagles and cajoles CHWC into making a three-percent profit - just enough so that a corporate hospital chain based in nearby Toledo or Fort Wayne, Indiana, won’t swallow it up. No one knows the depths of the problem more than Phil Ennen, CEO of Bryan’s Community Hospitals and Wellness Center and the central figure in The Hospital. This is not an uncommon predicament in the hollowed-out industrial parts of the country whose cities no longer feature steel mills and auto factories but competing knee-replacement centers. An Ohio native, Alexander spent two years reporting in Bryan, a small town in the state’s northwest corner where the jobs, benefits, and even the grocery stores have gone away, leaving a nonprofit hospital as the community’s soul and, unwittingly, it’s economic engine. That is the sad lesson at the core of Brian Alexander’s The Hospital. America is broken, but sometimes it takes looking at the smallest shattered pieces to realize how broken.

The Departure by Brian Alexander McCullough