Reviewed by The Honorable Jim Wright

This book is an anguished outcry for the healing of America’s health system. Whatever it may lack in literary style it more than makes up in hard-hitting facts and the passion of its author.

Rudy Mueller isn’t a writer, he’s a doctor.  A practicing physician for 20 years in upstate New York, he specializes in geriatrics and internal medicine.  But above this, he’s a family physician with a personal concern for his patients, and can’t just turn it off when remote and inaccessible bureaucracies deny them treatment that they need.

As Sick As It Gets is the outgrowth of this doctor’s hands-on experiences guiding plain and suffering people through times of pain, denial, frustration and even dehumanizing embarrassment at the hands of an aloof, profit-oriented “system.”

The narrative is laced with true stories of individuals patients confronted with formidable barriers to the most effective treatment for their illnesses. The inaccessibility of any form of health insurance to more than 43 million Americans, puts costly pressures on emergency wards.  Lacking coverage, Mueller explains, the uninsured forgo preventive treatment until advanced symptoms drive them to the most expensive forms of care.  This in turn fills emergency bays to overflowing, causing patients to be turned away, and adds needlessly to the medical bills of those who do have insurance.

Increasingly, doctors are forbidden by insurance companies and HMOs under pain of losing their right to practice in hospitals the HMOs control, from prescribing the most effective treatment or medication for their patients’ needs.

For Americans, conditioned to believe ours is the world’s best health care, Mueller presents some disquieting comparisons. While such centers as M. D. Anderson, Mayo’s and Sloan Kettering draw foreign patients by the multiple thousands, we lag behind every other industrial democracy in average life expectancy.  We suffer the highest infant mortality rate, the highest disability rate, and the highest per capita cost for treatment.

The author recites instances – too common, he says – when patients are hurried out of hospitals too soon, or forced to settle for second-rate treatment modalities, as well as cases where a commercial for profit hospital chain has forced the closure of community-based facilities.

We’ve all heard these stories. This book seeks to collate them into a shocking pattern of abuse conducted in the name of profit.  More and more physicians seem to be concluding, as Mueller does, that the answer lies in universal, publicly-provided coverage that leaves no American uninsured or untreated. As Sick As It Gets proposes a plan of action to that end.