‘So Much for That’ by Lionel Shriver is an odd book that is mostly about a terrible subject - dying slowly from incurable diseases while going bankrupt from copays and deductibles in the American health care system. Our criminally insufficient yet expensive private insurance coverage with its schedules of payments, secret rules about in-network and out-network services, and the Byzantine billing structure of separate bills from every doctor and clinic and lab and hospital is detailed in this interesting book.

The novel also describes, through the characters, a lot of angst about everything else in being a citizen of America. The incomprehensible maze of taxes, for instance.


The dying characters:

Glynis Knacker, sculpture/jewelry artist. Diagnosis: mesothelioma.

Flicka Burdina, seventeen-year-old high school student. Diagnosis: familial dysautonomia

Gabriel Knacker, retired minister. Diagnosis: old age.


Forty-eight-year-old Shepard Knacker wants to leave his fifty-year-old wife Glynis and move to Pemba, Africa. His daughter is graduating from college, his fifteen-year-old son Zack is growing roots in front of his gaming computer in his bedroom. Shep hates his boss. He has been saving money for decades in preparation of his lifelong plan of leaving America for “The Afterlife”. His portfolio has $731,778. He will give Glynis half although he thinks she didn’t earn any of it. Shep has asked her to leave with him many times. While she has enjoyed their vacations all over the world, she doesn’t want to move to a primitive place like Africa, even if it’s a vacation island where middle-class Americans could live like wealthy people.

Shep started a company, Knack of All Trades, two decades ago. It is a small construction company specializing in handyman tasks. It did very well, a going concern. Shep hired Jackson Burdina, his best friend, among others. One of his other employees, Randy Pogatchnik, a wealthy man, bought Knack for a million dollars eight years ago. Ever since, Randy has been changing Knack for the worse while at the same time picking on Shep, who stayed on as an employee. Shep was a decent employer. Randy is not. One of the things he changed was the company’s health plan. It is a cheaper one.

Bags packed and hidden in a closet, Shep once again asks Glynis to leave with him. Again, Glynis says no. But she has more to say this time. She tells him she has cancer. Silently, Shep unpacks his bags.

Jackson Burdina has a beautiful wife, Carol, and two daughters. Heather is healthy but feeling left out because her older sister Flicka is not healthy. Carol used to work until they found out what had been wrong with their firstborn, Flicka. Her disease is so terrible, gentle reader! Carol must work around the clock at home to keep Flicka alive. Health insurance is an absolute necessity in keeping Flicka alive as well. Her medication list is huge, as are the bills for the constant ER visits.

Shep’s sister Beryl is a documentary film artist. She seems to live primarily off of ‘loans’ from Shep, although she makes some money. Beryl is a leftist who complains loudly about capitalism and its built-in selfishness but she apparently does very little to help others. She is very healthy. She lives in Manhattan in a rent-controlled apartment she is subleasing. However, Beryl will have to find a new place because the landlord has decided to clean out all of the subleasers.

Shep tells her she should move in with their elderly father, Gabe, who needs much help with household activities in his house. He also needs a personal healthcare worker although he doesn’t think so. He can’t pay for a home healthcare worker. Gabe doesn’t have a supplemental Medicare plan. None of them know what they will do if he ever needs to go in a nursing home. Medicare does not cover nursing homes. Beryl protests and demands Shep give her some of the million dollars he has for a condo. Shep tells her the piggy bank is closed because of Glynis’s cancer.

Shep is too nice, gentle reader. Throughout the book, he always wants to do the right thing. But even more, he wants to be the guy everyone turns to for help. His schtick is he is the fix-it guy. Telling Beryl he can’t support her anymore is literally the first time he has said ‘no’ to anyone.

Jackson is having problems too. You’d think Flicka’s daily life-threatening issues would be more than enough to occupy him along with working at Knack, but Jackson is foolish. He thinks his wife is too good for him (Carol is as cool temperamentally as a snow queen despite Flicka’s mental and physical issues). So Jackson, who has to resist an urge to gamble now and then, has fallen for another kind of gamble - body enhancement surgery from a quack. It did not go well. He has two secret credit cards that Carol doesn’t know about, which paid for the surgery. These credit cards are in addition to the massive health care expenses of Flicka’s that insurance doesn’t cover.

Frankly, I am unable to decide which family is living in the worst hell caused by a family member’s poor health.

But that’s not all. These characters are normal Americans, plugged into social media, the news, and voting issues, caring/angry /concerned about the various Top Ten crises occupying the country. Also all of the stupid fads, the celebrities, the environmental causes, political scandals, the foodie craze, etc. etc. etc.

The noise and stress we Americans live with became very clear to me, reader. I am googling off-the-grid locations right after I type this period...