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

3.88  ·  Rating details ·  692 ratings  ·  47 reviews
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 t
Paperback, 297 pages
Published November 15th 1994 by University of Chicago Press (first published 1993)
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Average rating 3.88  · 
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Jennifer Richardson
Aug 21, 2009 rated it it was amazing
Should be required reading for anyone comparing the Obama health plan to Nazis, but then, they would have to know how to read. . .
Rebecca McNutt
Although it's important to take into account the decade in which this was published, unfortunately the issues it discusses are still quite common in America today due to flaws in the healthcare system. Why do some families face the horror of death when they shouldn't have to? Why can't everybody get equal care? This book addresses all of this and more, and it's not only a medical work but also an account of the families living through these situations every day.
Karen chandler/Hollander
Dec 29, 2018 rated it it was amazing
I highly recommend this book. I first read it when i was a new medical Social Worker in the Chicago Metro area. While we'd like think things have improved greatly in the 30 years since this was written and i first read it, the same struggles remain and the same inequity in available resources also remain. I have recommended this book countless times in my professional gatherings.
Harriett Burns
May 17, 2020 rated it liked it
I can't say that I enjoyed reading this book, but I'm glad that I did. The most depressing part of this pretty depressing book is that it was written in the early 1990's and I can't see that much has improved about our healthcare system in the United States. I started reading the book before the pandemic really hit the U.S. and it was hard to keep going after it hit. But it was leant to me by a respected friend and colleague so I kept going. And, in the end, it helps highlight all the reasons so ...more
Gloria Chen
Jul 18, 2017 rated it it was amazing
This book is a bit dated, but unfortunately, the issues discussed in it do not seem to have improved much in the 20+ years since it was published. I learned a lot reading it, and some of those thoughts are in this essay I wrote for the class it was assigned in:

(view spoiler)
Aug 21, 2012 rated it really liked it
Extremely eye opening book. There are a lot of things in this book that my parents and I just never experienced to this degree, and myself not at all because we had access to military health insurance from my father. This book sheds light on the fact that there are many policies that are failing to adequately cover many American citizens. This book ensures that you hear a little about what their day to day life is like and know about the hard choices that have to be made when you live in poverty ...more
Nov 10, 2008 rated it liked it
Fascinating look at the many failures of our health care system seen through the eyes of one Chicago family. I learned a ton about Medicare and Medicaid and all the laws involved. As much as she tells an important story, the tone was both inflammatory and accusatory as if Abraham was confused about her audience. The take home: Stay at home caretakers are incredibly hardworking, resourceful individuals.
Mar 10, 2010 rated it really liked it
Single-handedly started the process of me changing my mind on healthcare for those w/o insurance.
Suzanne Kelly
Jan 20, 2016 rated it really liked it
Even though this book is outdated (1993) it still does a great job in providing empathy to those who struggle in our country. There is still much work to be done.
Mar 24, 2018 rated it it was amazing
This book is close to 30 years old, but it’s tale still holds true. More people may have insurance, but public insurance and programs are still confusing, care is still expensive, poor people are still sicker than average, poor people have less access to quality care, and black people are disproportionately at risk of falling into this system.

If you think access to quality care is a privilege and not a right, you need to read this book. And then read it again. And again. And again until you und
Salvatore Daddario
Jun 27, 2019 rated it really liked it
I liked it!

(I actually didn’t finish. There are like 30 pages left, but I got everything I needed from it. I don’t have time to finish. Med school apps!!!!)

I think it’s a great read for someone looking to begin to understand just how confusing the medical system and insurance system are. This book has helped me hone exactly what I want my medical career to be, which is pretty cool. I want to educate people who need the education the most but that aren’t getting it. I am pretty sure that I want t
Fawkes Phoenix
Mar 21, 2019 rated it liked it
Frustrating. Very frustrating for the family how doctors, nurses, social workers, the whole medical system failed them. I feel it is a good example of what healthcare once was. But I don’t feel like it’s completely true anymore. Yes things are still bad and disparities most definitely still exist and still torment poor minorities. But a lot has changed and gotten better with ACA.

I think we still have a long way to go tho.

Ps I had to read this baby for school. I was forced. But ima count it.
Feb 01, 2019 rated it really liked it
Shelves: read-in-2019
A devastating longitudinal look at the failures of the health-care system for a family on Chicago’s Southwest Side. Caveats: was written in 1993, so some of the specific policies may no longer apply. Also, I found the tone quite condescending in some places. It made me wonder how the Banes felt about this portrayal of their most painful moments, and how a book like this might read from a reporter that shared some of the same demographic identity.
Jul 12, 2017 rated it it was amazing
Shelves: own
Even 25+ years later, the issues framed here hold true. The stats and specific policies may have changed slightly but the barriers and experiences of those navigating our uncoordinated system have not.
Aug 17, 2017 rated it really liked it
I originally was assigned this book for a social work in healthcare class but read another book instead. I picked it up a few years later-topic is wry interesting but writing is a bit dry. I would still recommend it
Feb 12, 2020 rated it liked it

Informative, but the insurance lingo got the best of me and there were many moments I zoned out. The parts of the book that surrounded the Baneses were more compelling for me.
Apr 22, 2020 added it
Wonder what this book looks like in 2019, post ACA, pre MFA. Cynically; just as depressing. Insightful, well researched, humanizing, brutal.
Tolu Rotimi
Jun 26, 2020 rated it liked it
The Baneses story line was the most interesting part of the book. The medicare/ medicaid poverty issues were disheartening and although dated feel as though they still exist even today.
Nov 02, 2007 rated it it was ok
Shelves: read-in-2008
2 gripes about the book:

(1) It presents problems - important and troubling problems, yes - but no viable solutions.

Okay, yes, we get it. The health care system is in shambles, creating vast inequalities in ability to pay for health care, quality of health care, and actual receipt of health care. Yes, health care has been turned into a commodity, rather than a public good. But how do you propose we remedy that, given today's political climate? Simply clamoring on about the poor who cannot afford
Jul 02, 2010 rated it it was ok
I didn't care for this public health classic. I read it to familiarize myself with the eminent Medicaid battles coming this fall. I wanted the author to go into more detail on Medicare & Medicaid policy. She stops short of any specific recommendations, which was frustrating too.

One thing the book did quite well was show the gap between those covered by Medicaid and those who cannot afford private insurance. I didn't realize $600/month income was not low enough to get covered by Medicaid. In othe
May 18, 2008 rated it liked it
Recommends it for: anyone interested in why we need health care reform in the USA
Recommended to Elizabeth by: College class--Inequalities and Health
Even though this book is now somewhat dated--I seem to recall that, when this book was written, managed medicaid plans were the exception rather than the rule--this is a tremendously good overview of the problems facing people in our inner cities with too many medical problems and too little access to good preventative health care. I credit it for interesting me in the field of health care for the underserved, and, so long as it is not being read for its policy explanations, which are dated, but ...more
Aug 17, 2008 rated it liked it
Recommends it for: anyone interested in health care
This is a good book - not a great one. It is interesting and nauseating at the same time. The book is an indictment of health care for poor, urban minorities and our American system in general.

The big struggle for me with this book is where you draw the line the problem being terrible access to quality health care and the abuse of individual responsibility.

Nonetheless, the book challenged me as to what I actually believe and opened my eyes to what is really going on. The saddest part - this bo
Dec 08, 2007 rated it it was amazing
Shelves: non-fiction-read
I know I like a lot of medical memoir type books, but this one was also excellent. Medical investigative journalist follows the Barnes family through the medical nonsystem of Chicago in early 1990’s. Grandmother with DM and subsequent amputations, Granddtr with hard time getting family into care and navigating system, her husband is drug abuser with early kidney failure s/p 2 kidney transplants. Discusses family issues, dialysis, system issues, poverty, Medicare/Medicaid. Fascinating.
Aug 23, 2010 rated it really liked it
Shelves: health
Great book. It follows the health of one poor, black family in urban Chicago and weaves it with history and analysis of the health care system in America. If you've ever wondered how Medicaid, Medicare, Social Security actually affects the lives of the poor on a daily basis, this is a great window into that.

I'd like to know what has changed since then (I know there have been minor reforms since then, such as with prescription drugs).
Mar 26, 2007 rated it liked it
Shelves: non-fiction
abraham focuses specifically on the experience of a poor, African-American family living in the slums of urban Chicago in order to provide an overview of the US health care system and its failings. she's a journalist, so the book is well-written and engaging but is occasionally more preachy and alarmist than factual.
Aug 22, 2007 rated it it was amazing
As if cost and availability of healthcare weren't enough burden to kill us all off by age 50, much of out urban black population has to put up with doctors and nurses who don't understand how to communicate with folks who aren't "mainstream." Horrifying ethnography.
Aug 13, 2008 rated it really liked it
definitely worth reading, really adds a layer of understanding of how our current health care system and government put impediments in the way of accessing health care. You really feel like Laurie Abraham got to know and care about the family she writes about.
Oct 06, 2012 rated it it was amazing
I read this book while I was working on the Affordable Care Act (health care reform). It was not only eye-opening, but inspiring as it reminded me -- in very personal ways -- why that piece of legislation had to become law. I just found my copy while unpacking boxes and I plan to re-read soon.
Mariam Taj
Jan 20, 2013 rated it it was amazing
At least, I was able to understand why such old book is still very much used today. It contents really touch many points that we still see and hear about today, unfortunately. God help us through all these issues.
Miriam Holsinger
Apr 09, 2013 rated it it was amazing
very eye opening! I never realized the barriers faced due to poverty and lack of education. the transportation issue was especially eye opening. The book was also well written. I just wish it was more current.
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