www.sandiegouniontribune.com /entertainment/books/story/2021-05-02/how-a-single-ohio-hospital-reveals-everything-thats-wrong-with-the-american-health-care-system

How a single Ohio hospital reveals everything that's wrong with the American health care system - The San Diego Union-Tribune

Denise Davidson 4-5 minutes 5/2/2021

When local journalist Brian Alexander was looking for the focus of his latest book “The Hospital: Life, Death, and Dollars in a Small American Town.,” the answer came easy: Bryan, Ohio.

“When I reported a story about rural hospitals for The Atlantic, I spoke to Phil Ennen, CEO of Community Hospitals and Wellness Centers, or CHWC,” said the award-wining author. “After the story came out, Phil asked me to come to Bryan, talk to some people and have a look at the hospital.

“During my visit, I realized that by using the lens of one small hospital in one small town, I could say some things not only about American medical care, but about America in general. Though every place is a little different, CHWC and Bryan are avatars for the whole country.”

“The Hospital” breaks down the complexity of a community hospital, its patients and their economic ability to pay for medical care. Also, it traces the history and magnitude of America’s health care crisis.

Alexander’s previous book, “Glass House: The 1% Economy and the Shattering of the All-American Town,” won multiple non-fiction awards, including the Ohioana Award and was a finalist for the California Book Awards.

Alexander — who grew up in Lancaster, Ohio, and and now lives in San Diego — also wrote “Rapture: A Raucous Tour of Cloning, Transhumanism, and the New Era of Immortality” and “America Unzipped: In Search of Sex and Satisfaction.”

Q: Why isn’t health care easily affordable, and is it a privilege to have it?

A: Health care is not easily affordable because over the past 100 years, we as a nation have decided not to let it be easily affordable. Prices reflect policy. And, unfortunately, in this country, good medical care is still a privilege and not a right. The fact is, rich people live longer, healthier lives. And the American economy itself is killing people.

Q: Who are Phil Ennen and Keith Swihart?

A: Phil Ennen is the CEO of Community Hospitals and Wellness Centers. Keith is a man I’ve followed for about two and a half years now, as I followed several other individuals who appear in the book. As the book opens, he’s a hardworking fellow with a wife and little boy. That changes as the book goes on, and Keith finds himself victimized by both the American economy and American medical costs. In Keith’s case, the first cost is the insulin he needs to treat his diabetes.

Q: How has national politics played into running a local hospital?

A: For over 100 years, this nation has argued about how to provide medical care for its people. Those arguments most often take place in the political arena. So no part of American medical care is free from politics, whether it’s running a small hospital, treating patients as a doctor, being a patient or even being able to access healthy food.

Q: What can people do to make medical care affordable?

A: Vote for it.

Q: What two things surprised you most during your research?

A: I was surprised by just how completely the lingo and posture of business has usurped American medicine. I was surprised by the willingness of people to keep trying to work hard, to keep obeying rules, to keep ginning up their faith — both religious and in the American way of life — when so much of their experience would seem to militate against it. That people are not constantly in the streets surprises me sometimes.

Q: What is your prediction for the future of health care?

A: My hope or my prediction? My prediction is that Wall Street, in the form of private equity investors and other financial outfits, will take increasing control of American medicine. Health care is now the largest chunk of the American economy. It’s where the money is. The industry will become more and more concentrated. Patients will have smaller and smaller voices. Ultimately, though, if those trends continue, the insurance model will collapse. My hope is that none of that happens and we create a real national health plan.

Q: What’s your next writing project?

A: I am working on a new book. I don’t want to say much about it now, but it will seem like a departure from my last two books, though. It’s a natural extension of those themes: How can we make a better America?

“The Hospital: Life, Death, and Dollars in a Small American Town” by Brian Alexander, St. Martin’s Press, 320 pages.

Davidson is a freelance writer.