After enjoying We Need to Talk about Kevin hugely, I was looking forward to this as one of my beach reads this Summer. Well of course, there is the usual problem of how can you follow up such a dramatic book, you can’t really, but once you get into this it is a good read. It highlights some of the major injustices and inequalities of health care in America and also examines the idea of whether you can change your life by moving to another country. It also asks a fundamental question – how much should you pay for a human life? Is it worth paying $2 million to extend a life three months if someone is terminally ill?
The story deals with Shep, a handyman who has always paid his taxes, abided by the rules and respected authority. After years of planning to emigrate he finally buys one way plane tickets to Pemba an island in Tanzania, but his plans are scuppered when his wife tells him she has a rare form of cancer and she needs to use his health insurance. Shep is so ridiculously nice that he has spent his whole life letting others take advantage of him, he pays for his wife and sister to follow their vocations and essentially never work. As he says in the book, why is it those who have never earned any money themselves that accuse people of being money obsessed? You are just desperate for him to tell his unbelievably selfish sister Beryl to sod off. The book also has a particularly horrific penis enlargement. The focus however is on three key characters and their fight to stay alive and maintain some dignity. Each chapter shows Shep’s dwindling bank account as he pays more and more money to fight Glynis’ cancer and to pay for his father’s care home, despite the fact he has health insurance.
It makes you so angry that a country as supposedly developed as America can treat its people like this. The novel briefly refers to the history of the health insurance system and how Truman tried to introduce a free health care system but opponents branded it ‘state socialism’ which in paranoid 1950s Communist America was enough to finish it off.
For someone who changed their own life by moving abroad, in my case running off to the Seychelles I enjoyed the fact that it tackles the question of whether this is just running away or a great way to change your life. The book ends optimistically with the idea that yes, it is great – so do it now!
It shows a more realistic view of cancer and challenges the idea that if you ‘fight’ the disease you will win and that if you die, you have failed. It is overlong in places but an enjoyable and thoughtful read,