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Reading:3 8/15/07 3:36 PM Page 20 Rather than argue where his arguments and heart seem to lead him, towards a single-payer system, Cohn argues that a hybrid system might function just as well.Such a system would attempt to achieve universal healthcare through a mix of government and private insurers. In other words, almost exactly what we have now. Other common maladies of slaves come to light in subsequent chapters, where we get an in-depth review of the healthcare of blacks on the plantation. The reader is perhaps surprised—or at least chagrined at the irony—to learn that the health of blacks was of the utmost importance to their white owners since they viewed slaves as investments in property they needed to protect. It was not uncommon, in fact, for plantation owners and overseers to complain that their slaves did not come to them sooner with their health concerns, which they argued led to greater harm and medical expense when neglected for too long. Savitt proposes at least one reason for many blacks' reluctance to seek out help from white medical practitioners: many of the treatments, while effective when administered to whites, had a deleterious effect on black patients. The often harsh treatments by white healthcare workers compelled blacks to seek out treatment within their own communities, which, we learn, had its supply of healers who combined their knowledge of "white" remedies and traditional, African-based herb medicine. No book on the healthcare of antebellum and Reconstruction-era blacks would be complete without investigating the use of black bodies—slave and free, alive and dead—for medical experiments. In one of the more disturbing accounts, Savitt details how one enslaved Georgia man in the 1820s was forced to stand in an oven-like pit for an extended period over the course of several weeks by a physician who was attempting to find the best remedies for heatstroke. By the end of Savitt's disturbing account of medical experimentation, we are more than ready for the story of African Americans' entry into the medical profession and their struggle to gain control of their own healthcare. We learn about some of the earliest failed attempts at establishing medical schools to train blacks as physicians after the Civil War. Savitt's chronicling of the rise and fall of medical schools for blacks reveals an ongoing struggle to obtain financing in an environment often hostile to black advancement in medicine. When turnof-the-century black physicians did enter the profession, they faced many difficulties. African American physicians were not trusted by many blacks, who relied instead on healing systems, such as root work and magic, brought over from Africa and the West Indies. And, when they were called on for treatment, they often could not obtain sufficient payment for services from poor Southern blacks. Savitt's book as a whole is an engaging examination of how race 20 REGISTERED NURSE and medicine intersected during the most racially segregated period of American history, introducing us to some of the lesser-known heroes and trailblazers in the ongoing struggle to provide equal access to healthcare for the most indigent and voiceless Americans. —angela rowen Sick: The Untold Story of America's Health Care Crisis—And the People Who Pay the Price by Jonathan Cohn. 302 pp., $25.95 B efore Sicko, there was Sick. Michael Moore's movie brought the healthcare debate to the big screen, but Jonathan Cohn's book Sick helped kick off a national conversation about the healthcare crisis our country faces and how we can cure it. Sick does good work diagnosing the problem, but unfortunately falters in prescribing remedies. Like Sicko, Sick tells the story of a number of patients, using the victims of the health-industrial complex to chart its effects. Their experiences are heart wrenching, enraging, and all too familiar. We meet the family who lost their mother because she was uninsured; we meet the family who lost their father because Medicaid cut back on his heart medicine. And so on. But where filmmaker Moore focuses his lens squarely on the current crisis, author Cohn has the space and time to tell the historical story of the rise and failure of an American medical system built on private insurance. The patients he introduces us to all illustrate particular developments in this story. Cohn's stories describe that American healthcare in the 20th century developed as a system to help insurers, hospitals, doctors, and politicians make a buck—and that patients, especially the most vulnerable ones, were ill-served by a system they replied upon but could not trust. Of course, even in a book as well-documented and researched as Cohn's, the explanations can only go so far. In the 1930s as the rest of the industrialized world began to turn to guaranteed, national healthcare, why did the United States turn the opposite way and instead invent new insurance products? In the 1930s, and '40s, '50s, '70s, and '90s as genuine healthcare reform was raised, why was it defeated every time? It's well documented now that the insurance and hospital industries, with the help of the American Medical Association, blocked national healthcare at every turn. History has taught us where we should go next. And that's where Sick fails us. It seems almost as if the conversation changed between when it was written and when it was published. The book is written to convince readers of the need for universal healthcare. We all now acknowledge this, right? Nurses, patients, and conventional wisdom all seem to realize that we should have healthcare for all and we should have it now.That debate is over. W W W. C A L N U R S E S . O R G J U LY | A U G U S T 2 0 0 7