The People's Hospital
Hope and Peril in American Medicine
Where does one go without health insurance, when turned away by hospitals, clinics, and doctors? In The People’s Hospital, physician Ricardo Nuila’s stunning debut, we follow the lives of five uninsured Houstonians as their struggle for survival leads them to a hospital where insurance comes second to genuine care.
First, we meet Stephen, the restaurant franchise manager who signed up for his company’s lowest priced plan, only to find himself facing insurmountable costs after a cancer diagnosis. Then Christian—a young college student and retail worker who can’t seem to get an accurate diagnosis, let alone treatment, for his debilitating knee pain. Geronimo, thirty-six years old, has liver failure, but his meager disability check disqualifies him for Medicaid—and puts a life-saving transplant just out of reach. Roxana, who’s lived in the community without a visa for more than two decades, suffers from complications related to her cancer treatment. And finally, there’s Ebonie, a young mother whose high-risk pregnancy endangers her life. Whether due to immigration status, income, or the vagaries of state Medicaid law, all five are denied access to care. For all five, this exclusion could prove life-threatening.
Each patient eventually lands at Ben Taub, the county hospital where Dr. Nuila has worked for over a decade. Nuila delves with empathy into the experiences of his patients, braiding their dramas into a singular narrative that contradicts the established idea that the only way to receive good healthcare is with good insurance. As readers follow the movingly rendered twists and turns in each patient’s story, it’s impossible to deny that our system is broken—and that Ben Taub’s innovative model, which emphasizes people over payments, could help light the path forward.
Physician Nuila debuts with a troubling yet inspirational look at the state of healthcare for America's "most medically and financially vulnerable." Spotlighting Ben Taub Hospital in Houston, Tex., "the largest safety-net hospital in one of America's most diverse cities," Nuila profiles seven patients caught up in a system that denies them life-saving medical care due to their lack of resources, and reveals the difference being treated with dignity can make. The book's most harrowing sections recount the story of Geronimo (no last name given), a 36-year-old Mexican immigrant suffering from epilepsy, hepatitis C, and liver disease. With the help of hospital staff, Geronimo had previously applied for and been accepted into Medicaid, which would have paid for a liver transplant, only to have it revoked because his monthly disability payment was $179 too high. (He would have been covered in other states, Nuila explains, but Texas refused the Affordable Care Act's Medicaid expansion.) Though a U.S. congressman intervened and Geronimo's Medicaid coverage was reinstated, he died before a transplant could be scheduled. Woven into this and other, more hopeful, case studies are poignant reflections on the life of a doctor and incisive analyses of how for-profit medicine hurts patients. This is an urgent and essential call for a more humane healthcare system.