Interesting and skewed take on dialysis in America. The vast majority of healthcare in this country is for profit, so to position dialysis as the leading problem is biased. The biggest differentiator is that dialysis is government funded which, in my opinion, all healthcare should be. The author regularly refers to money spent by patients, which compared to other types of healthcare, is pretty limited.

The book implies that people are on dialysis because a dialysis clinic has moved into the area based on the racial makeup of the residents. Systemic racism is definitely a factor for who ends up with kidney failure, but the clinic is a response to that, not a cause. Removing the clinic won’t make less people need it.

Top execs making really large profits is the norm in most healthcare settings, including dialysis. I agree that this needs to change and more of that money would end up on patient care in a non-profit world. The entire system is broken, but that’s not the fault of one portion of the industry.

Aside from all my above (and many other) issues with the content of the book, the writing also wasn’t great. The chapters are all over the place without telling a cohesive story. The author talks about a dialysis advocate and mentions her trailer home no less than 3 times during the book, including at the end to let us know she’s in a nicer home now. Completely irrelevant and pretty insulting. He also wraps up with an attempt to tie this back to other cultural issues we’re facing, along with the inability for people to end their own lives. This has no relevance and just further sensationalizes the topic.

Anyone in the healthcare industry should be aware of the nefarious side of profit-driven dialysis. This book paints a stunning portrait of the hopeful beginnings of dialysis, to the current sad state of affairs, as well as the people who are affected on all sides. My heart goes out to those forced to be in dangerous situations produced by the “fast food model” of healthcare.

I was a HUGE fan of EXTRA VIRGINTY many years ago so, I jumped right into this. It's a Medical/Business expose with tons of crazy characters as well as ordinary people. I tore through this. If you need dialysis, you've got to hope you have REALLY good insurance and probably a strong advocacy team on your side. Whoa.