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A novel approach to health care

Guest Blogger

As the decades-long health care debate reaches a climax in Washington this week, Lionel Shriver has released a powerful novel that puts flesh on the issues. "So Much For That," reviewed today in the Style section, is an angry demonstration of everything that's wrong with our medical system. The story is riddled with medical bills, insurance claims, tax laws and employment regulations. We asked Lionel Shriver about the special dangers and benefits of writing fiction that runs so close to the current political situation.

By Lionel Shriver

The sole reason that political issues are ever important is that they have implications for the nitty-gritty, searingly personal experience of individual people. This is surely the reason that fiction is the ideal vehicle for exploring matters that in the abstract are killingly dull and deceptively dry. Story puts flesh on desiccated subject matter. Thus in my seventh novel, "We Need to Talk About Kevin," I took the tedious “nature vs nurture” debate and goosed it to life. When you’re a mother terrified that your own ambivalent, loveless parenting may have turned your son into a killer, that “nature vs nurture” stuff is no longer merely academic.

I’m hoping that the state of American health care is another topic that fiction can animate, in contrast to the listless, inert drone of the news. All those articles about tax breaks, pre-existing conditions, and Medicare fee structures leave readers confused, exhausted, and bored to death.

In "So Much for That" I tried to vivify one of those dry statistics: The leading cause of American bankruptcies is medical bills, and the majority of those bankrupts have health insurance.

For money itself is not dry, but highly emotional; earned income represents years of toil, our very lives. Like so many of his countrymen, my protagonist Shep Knacker has worked hard for his savings; he built his own business from the ground up. Also like many Americans, he has not saved his pennies merely to hoard his wealth; he has plans for them: all his life he’s conserved his funds in order to quit the rat race altogether and retreat to a Third World economy, where his savings will last forever and he can live in simpler, more contemplative freedom from the West Side Highway.

But Shep’s plans for what he calls The Afterlife are imploded when his wife is diagnosed with a deadly and expensive cancer, and with all the extras his insurance doesn’t cover, like her out-of-network physicians, his precious nest egg is smashed.

Obviously, writing overtly political “issues” novels is dangerous. Fiction readers don’t want to read polemics or op-eds, and they don’t want to be lectured. Moreover, a too-topical novel is destined to date in short order; I wouldn’t have wanted to write a book that could be made instantly obsolete by a reform bill passed in Congress.

But fiction is well suited to tackle moral complexity, and to connect a particular era’s politics to greater issues that are timeless: illness, death, and the nagging, unanswerable question that is dogging all Western countries’ medical systems: how much is one life worth?

For in an age when it’s possible to spend millions on one individual’s survival for a few more months of often miserable existence, we’re going to have to ditch the old saw that “you can’t put a dollar value on human life.”

My readers will have to judge, of course, whether I’ve successfully brought the health care debate to life. Nevertheless, behind all the policy wrangling in Congress lurk millions of American families experiencing heartbreaking, soul-destroying devastation of their hard-won resources. Story -- among many stories -- is the only reason that this issue matters at all.

By Steven E. Levingston  |  March 17, 2010; 5:30 AM ET
Categories:  Guest Blogger  | Tags: health care reform and fiction; lionel shriver; so much for that;  
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Comments

The sad thing is that President Obama put himself in this predicament of "something is better than nothing" by giving away the store at the start.

1.Took single payer, i.e., medicare for all, off the table from the very start even though that could have passed via reconciliation since medicare already exists.
2.Took re-importation of prescription drugs off the table with his secret deal with the pharma industry, even though he promised not to make backroom deals like that.
3.Didn't fight back hard when Stupak and Nelson put in their abortion restrictions language.
4.Fought back super hard when members of congress and the unions tried to excise the excise tax.
5.Didn't fight for the amendment to allow states to create their own single payer systems.
6.Didn't fight for the pre-existing condition for adults to kick in this year like it does for kids. So instead, they're waiting until 2014 along with a hell of a lot of other provisions.
7.Didn't put in rate increase limits on the insurance industry so they can continue to raise rates in the double digits even if they can't drop people for pre-existing conditions or getting sick and becoming too expensive.
So great, you can't be dropped but you can certainly be priced out of coverage. Wonderful reform that is!

Is it good policy?

Not in any way shape and form.

Posted by: easttxisfreaky | March 17, 2010 12:00 PM | Report abuse

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