I think Lionel Shriver is a fantastic writer - We Need to Talk About Kevin and The Post Birthday World are two of my favorite books. This one, while still good, just isn't great.

The book is about the American health care system and how much it sucks. There are four medical crises in the novel, each of which cause total destruction to families' finances despite the fact that all of the sick people actually have health insurance.

Now, when I'm reading it (being a liberal and all), Shriver is preaching to the choir. The thing is, though - she's actually preaching. The "dialogue" between Shep and Jackson explaining America's health care system is stilted and doesn't ring true. She clearly has an agenda, and I wonder if a nonfiction book on the subject might have been better.

A few other things that I didn't care for - the character of Glynis. She's made out to be a terrible woman. Really, who would be friends with her or bankrupt themselves to pay for her chemo? I feel like despite her nastiness, there has to be something that keeps people around her, and I didn't get that from the novel. Same thing with Beryl - she was so over the top as to be almost unbelievable.

I did like the character of Shep, the husband. And I liked the Afterlife, the retirement in Africa that he strives for all his life. And I thought the ending was great.