Book review of The People’s Hospital by Ricardo Nuila

As COVID-19 swept across the United States in 2020, health care professionals and patients quickly learned about the flaws in the public health system. Questions arose about equitable access to health care, the role of insurance and the quality of care in public hospitals serving uninsured people versus private hospitals serving people with private insurance. Taking the public Ben Taub Hospital—Houston’s “largest hospital for the poor . . . who cannot afford medical care”—as an example, medical researcher and practicing physician Ricardo Nuila explores these issues in The People’s Hospital: Hope and Peril in American Medicine.

Nuila has been an attending physician at Ben Taub for over 10 years, and he has discovered that “good care comes from connecting with your patients in whatever way you’re able.” Using the stories of five patients, Nuila weaves an intricate web of questions about the shortcomings of insurance and corporate medicine and reveals how Ben Taub has succeeded in providing access to health care for people who are medically and financially vulnerable.

For example, there’s Christian, a patient with chronic kidney disease who developed mysterious, debilitating knee pain. Because he was uninsured and had to pay out of pocket for his diagnosis and treatment, he traveled to a clinic in Mexico where he hoped his money would go further. A few weeks into his therapy, his knee pain diminished, and he moved back to Houston—but within weeks, he found himself facing the same medical issues again. When his kidneys started to fail and the insurance company denied him coverage, his mother admitted him to Ben Taub, where he started receiving hemodialysis on a regular basis and eventually left the hospital with hope.

Readers also meet Ebonie, who was 19 weeks into her pregnancy and experiencing dangerous levels of obstetric bleeding. After bouncing from hospital to hospital, she eventually landed at Ben Taub, where Nuila and another doctor developed a plan to deal with bleeding in the future and made sure she would be admitted to Ben Taub when it happened. Ben Taub also helped Ebonie apply for Medicaid so she would have an insurance safety net. Through his own experiences, and those of his patients and fellow health care professionals, Nuila paints a picture of a world where “people find healthcare and revere it like treasure.”

The People’s Hospital is an inspiring book that raises crucial questions about the future of American health care. Nuila illustrates that hospitals that make holistic decisions about care provide more effective and equitable treatment than those that ask simply about the ability of patients to cover expenses, reminding readers that the most effective health care systems always elevate humans and their needs over monetary gain.