Mama Might Be Better Off Dead: The Failure of Health Care in Urban America by

Laurie Kaye Abraham

Published by University Of Chicago Press, 1993
ISBN 10: 0226001385 / ISBN 13: 9780226001388
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Synopsis: Mama Might Be Better Off Dead is an unsettling, profound look at the human face of health care. Both disturbing and illuminating, it immerses readers in the lives of four generations of a poor, African-American family beset with the devastating illnesses that are all too common in America's inner-cities.

The story takes place in North Lawndale, a neighborhood that lies in the shadows of Chicago's Loop. Although surrounded by some of the city's finest medical facilities, North Lawndale is one of the sickest, most medically underserved communities in the country. Headed by Jackie Banes, who oversees the care of a diabetic grandmother, a husband on kidney dialysis, an ailing father, and three children, the Banes family contends with countless medical crises. From visits to emergency rooms and dialysis units, to trials with home care, to struggles for Medicaid eligibility, Abraham chronicles their access (or lack of access) to medical care.

Told sympathetically but without sentimentality, their story reveals an inadequate health care system that is further undermined by the direct and indirect effects of poverty. When people are poor, they become sick easily. When people are sick, their families quickly become poorer.

Embedded in the family narrative is a lucid analysis of the gaps, inconsistencies, and inequalities the poor face when they seek health care. This book reveals what health care policies crafted in Washington, D. C. or state capitals look like when they hit the street. It shows how Medicaid and Medicare work and don't work, the Catch-22s of hospital financing in the inner city, the racial politics of organ transplants, the failure of childhood immunization programs, the vexed issues of individual responsibility and institutional paternalism. One observer puts it this way: "Show me the poor woman who finds a way to get everything she's entitled to in the system, and I'll show you a woman who could run General Motors."

Abraham deftly weaves these themes together to make a persuasive case for health care reform while unflinchingly presenting the complexities that will make true reform as difficult as it is necessary. Mama Might Be Better Off Dead is a book with the power to change the way health care is understood in America. For those seeking to learn what our current system of health care promises and what it delivers, it offers a place for the debate to begin.




Excerpt. © Reprinted by permission. All rights reserved.: Two decades worth of Mrs. Jackson's medical history were never transferred from Dr. Marino to Mount Sinai, as would be routine for middle-class patients. Her new physicians may have assumed that, like many other poor blacks, she did not have any regular source of primary care, or that the information from a "storefront doctor" would not have been reliable.

When dialysis was introduced in the 1960s as the first treatment for otherwise fatal renal failure, there were not enough machines to meet the demand, so doctors and others decided who would receive the lifesaving treatment. The most infamous example of that process was in Seattle, where a committee comprised of a lawyer, minister, housewife, labor leader, government official, banker, and three physicians decided who would live and who would die. The group, whose deliberations were chronicled in Life magazine, was biased toward patients who held good jobs and supported families who otherwise might be on the public dole. Divorce was frowned upon, as was a poor education.

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Title: Mama Might Be Better Off Dead: The Failure ...
Publisher: University Of Chicago Press
Publication Date: 1993
Binding: Hardcover
Book Condition: New

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