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Mama Might Be Better Off Dead: The Failure of Health Care in Urban America, by Laurie Kaye Abraham
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Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care. Both disturbing and illuminating, it immerses readers in the lives of four generations of a poor, African-American family beset with the devastating illnesses that are all too common in America's inner-cities.
The story takes place in North Lawndale, a neighborhood that lies in the shadows of Chicago's Loop. Although surrounded by some of the city's finest medical facilities, North Lawndale is one of the sickest, most medically underserved communities in the country. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Abraham chronicles their access (or lack of access) to medical care.
Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty. When people are poor, they become sick easily. When people are sick, their families quickly become poorer.
Embedded in the family narrative is a lucid analysis of the gaps, inconsistencies, and inequalities the poor face when they seek health care. This book reveals what health care policies crafted in Washington, D. C. or state capitals look like when they hit the street. It shows how Medicaid and Medicare work and don't work, the Catch-22s of hospital financing in the inner city, the racial politics of organ transplants, the failure of childhood immunization programs, the vexed issues of individual responsibility and institutional paternalism. One observer puts it this way: "Show me the poor woman who finds a way to get everything she's entitled to in the system, and I'll show you a woman who could run General Motors."
Abraham deftly weaves these themes together to make a persuasive case for health care reform while unflinchingly presenting the complexities that will make true reform as difficult as it is necessary. Mama Might Be Better Off Dead is a book with the power to change the way health care is understood in America. For those seeking to learn what our current system of health care promises and what it delivers, it offers a place for the debate to begin.
- Sales Rank: #48825 in Books
- Brand: University of Chicago Press
- Published on: 1994-11-15
- Released on: 1994-11-15
- Original language: English
- Number of items: 1
- Dimensions: 9.00" h x .90" w x 6.00" l, .90 pounds
- Binding: Paperback
- 289 pages
- Great product!
From Publishers Weekly
The vicious circle of poverty and illness is powerfully portrayed in Abraham's ( Reinventing Home ) account of an uninsured, black, four-generational family in one of Chicago's "poorest and sickest" neighborhoods. Included in their medical misfortunes: the amputation of both legs of a diabetic grandmother; a drug-addicted husband on kidney dialysis who undergoes a kidney transplant; a partially stroke-paralyzed son; and children who lack primary care and immunization. This personally observed, lucid chronicle and call for reform of our ailing health system covers all levels of responsibility in the medical establishment, and deserves scrutiny by our administration's health service planners. Abraham concludes that a reformed health care system should set limits on health spending while stressing "caring" over "curing."
Copyright 1993 Reed Business Information, Inc.
From Library Journal
This is a refreshing chronicle of the inadequate patchwork of federally funded health programs caring for our nation's urban poor. Journalist Abraham uses the medically plagued Banes family as a springboard for his analyses of the convoluted, mysterious, and at times nonsensical healthcare system that holds the urban poor captive. Unlike Alex Kotlowitz, whose There Are No Children Here ( LJ 4/1/91) elucidates the glaring inequities in our social system through the powerful story of two boys, Abraham uses the Banes's ill health as a pulpit for reciting numerous studies, quoting scholars, and commenting on current policy debates. Abraham does an excellent job of explaining the maze of healthcare programs available to the urban poor. More importantly, he clearly identifies in human and policy terms how these same programs have failed a population desperately in need of help. Recommended for most collections.
- Karen A. Wolin, Univ. of Illinois Coll. of Medicine at Chicago
Copyright 1993 Reed Business Information, Inc.
From Kirkus Reviews
Cool yet compassionate eyewitness report of an inner-city black family's struggle to cope with sickness and poverty. Abraham, expanding on articles she wrote for The Chicago Reporter, demonstrates brilliantly just how confusing and cumbersome our national health-care system has become. From May 1989 to April 1990, Abraham followed the (pseudonymous) Banes family as its head, Jackie, cared for her bedridden diabetic grandmother; her alcoholic, partially paralyzed father; her drug-abusing husband, on thrice-weekly dialysis following kidney failure; and three young children. The labyrinthine mysteries of Medicare and Medicaid are daunting even to the Yale-educated author, yet Jackie must make what sense of them she can in order to keep her family going. Still, services that might have protected the children's health or lightened the family's burdens often aren't taken advantage of thanks to confusion about how the system works, lack of information, and the overwhelming job of simply surviving from one day to the next. Abraham concentrates on two stories--that of Jackie's grandmother, whose condition worsens, requiring hospitalization, then nursing-home care; and that of Jackie's husband, who receives a second kidney transplant. Both stories raise the issue of rationing: Could the $120,000 spent on the final months of the grandmother's life have been better utilized? How should recipients be selected for scarce organs? Abraham's depiction of the Baneses' plight reveals serious flaws in our health-care system, but the more basic problem is seen to be the devastating social illness of our inner cities, an illness no national health plan can cure. Abraham doesn't pretend to have the answers--but she illuminates the problems with passion and skill. -- Copyright ©1993, Kirkus Associates, LP. All rights reserved.
Most helpful customer reviews
20 of 24 people found the following review helpful.
DON'T BE PUT OFF BY THE TITLE
By A Customer
As a graduate student writing my thesis on urban health care issues, I must say this book is a gem! Laurie Kaye Abraham makes the most compelling arguments for health care reform in this book while walking the fine line of objectivity at the same time. Now I know I can truly say that I understand why many urban areas suffer from some of the same public health woes as third-world countries. Thank you, Ms. Abraham for inspiring me and thanks to the Banes family for allowing us into their lives.
10 of 11 people found the following review helpful.
A wake-up call for the U.S.
By A Customer
The U.S. government would like us to think that we, being the lone superpower in the world today, have all of our own internal problems solved. Not so. There are millions of uninsured and underinsured people (many of them children) in the U.S. who struggle to meet their own basic (and more advanced) health care needs. This is often a foreign world to Americans raised with good health insurance coverage. Yet Abraham shows us that we cannot ignore the health care problems in our own backyard.
As a recent college graduate who is entering medical school this fall, I was challenged to think carefully about how I will choose to practice medicine in the coming years. Given what I now know, I feel a responsibility to help change the plight of the uninsured.
As a final word, the only reason I gave this book 4 stars instead of 5 is because the personal narratives, while very revealing, get a little long-winded at times. Otherwise, it is a great book, one that I anticipate referencing frequently in the coming years.
10 of 11 people found the following review helpful.
A Must Read for Those Interested in Health Care Issues
By A Customer
I found this book to be a great resource for a description of health care coverage for the lower income bracket individuals and families. It discussed many of the loops that people have to go through in this process and how simply getting to the doctor's office is out of reach without the right resources. This was an insightful albeit incredibly difficult book to read. Health care workers should read this and get a feel for how something that seems very easy to say is almost impossible to do...this is worth the time and money!
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