Shep Knacker essay

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Shep Knacker is the main character in Lionel Shriver’s latest novel, “So Much for That.” Shep believes his life will start in earnest the moment he quits the rat race and take a journey to Pemba, a TanzanianIsland whose main attraction is the low living cost. After we meet Shep and learn about his commitment to embark on life after, he is truck with the news that Glynis, his wife has a rare cancer illness known as peritoneal mesothelioma. This ultimately puts Kibosh on his plans. With strangely exultant coolness, she informs Shep that she prefers not going. She desperately needs Shep’s health insurance (Shriver, 2010).

Co-pays, lifetime payment caps, deductibles as well as out-of-network providers all are part of Shep’s vernacular. At first, he navigates the illness and treatment of his wife. Later on his octogenarian father breaks up his leg and should be moved. This is all at the expense of Shep into a home of insurance. This idiom of illness gets into the way he perceives his predicament. His Pemba nest egg falls off. Consequently, Shep thinks that he is “hemorrhaging” money. He sees the surgery on his wife, Glynis as “gouging a meaty chunk” from his assortment, as if to financially mirror the hostility inflicted on his wife’s belly (Shriver, 2010). On the other hand, his thoughts on mortality match the language of money. According to him, the fact that his wife is dying at 51 years of age is “owed” an “astronomical debt.”

As he visits his father who is a retired minister in the home of nursing, Shep is so surprised that the amount of money that an individual has to pay to keep somebody alive. His father parses the issue more delicately by asking what a life can be in terms of dollars. If the ensuing dialogue of the scene is salted with such phrases like expenditure cap, generic ibuprofen and cost-­effectiveness, then that appears to be more appropriate to an editorial on the debate of health care than to a close exchange between ailing paterfamilias and mournful son. This could reflect the journalistic status of Shiver as a customary contributor to The Guardian of London. There is no problem in writing a newsworthy novel. However,  these prodigiously exhaustively and researched argued critiques at times read more or less like excerpts from a position paper (Shriver, 2010).

Public health care also is evident most importantly in the story of Jackson, the best friend to Shep. For one, his friend’s daughter who is 16 years old has familial dysautonomia. Familial dysautonomia is a congenital degenerative condition that needs occasional medical treatment and ultimately since Jackson goes through elective plastic surgery on a particular part of his lower anatomy. The said operation, dreadfully failed leading to various reconstructive surgeries, themselves both exorbitant and disappointing. This consequently leads to the devastation of Jackson’s marriage as well as the bankrupting of the entire family (Shriver, 2010). Even though this aggressive swerve into what looked like a whole diverse subgenre initially strikes the reader as jarring. The reader could think that Shriver has comedic intentions. 

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Micah et al. (2008) on U.S Health spending by Age and Cunningham and May (2006) tackle a subject on the financial implications of public health. Micah et al. (2008) examines the differences in health spending amongst children, the working-age adults and the seniors. The study covers the years between 1987 and 2004. Every category seems to be struggling in its own capacity while catching up with the public health bills. This is the same case with Shep Knacker in the novel, “So Much for That.” Seniors spend relatively higher than the working-age adults and the children. However, the rate of spending has not changed since 1987 except for individuals who are eighty five years and more. From the inception of the children’s health insurance program by the state in 1997, the ration of the children’s spending through public funding has consequently increased. The share paid for from the pockets of the citizens has largely decreased. This article exhibits the challenges which are similar to those of Shep as he tries to come to terms with the realities of public health expenditure on his wife and his friend, Jackson. The future age-mix is anticipated to have a very huge impact on the home of nursing spending increase as it insignificantly affects the overall spending growth on Medicare.

On the other hand, Cunningham and May (2006) assert that the ratio of the U.S. physicians who accept Medicaid patients has decreased to some extent over the last decade. This is backed up by a countrywide study through the Center for Studying Health Systems change. It is recorded that about 15% of the physicians reported that they did not get any revenue from Medicaid between 2004 and 2005. This number alarmingly increased from about 13% in the 1996-1997 fiscal year. There was in addition a small increase in the number of physicians who did not accept new Medicaid patients during that time. A more alarming trend is that the care of Medicaid patients has been increasing in concentration amidst a smaller number of physicians who have been practicing in huge groups, academic centers, hospitals and community health centers.

Relatively, low rates of payment and the high administrative costs are likely contributors to the decreased involvement of the physicians with Medicaid in both individual and group practices. Generally, Cunningham and May (2006) expound on the challenges faced in the administration of public health care in terms of funding. The same issue apparently takes center stage in “So Much for That” as highlighted by Shrivel through the protagonist, Shep and his close associates in the Novel. The Public health system seems to have been neglected and thus lacks proper systems to make service delivery good. Public health is a major issue that is evident in these peer reviewed works as is also highlighted in Shriver’s novel. Shep is finding the expense of medical health hard to come by. There are indicators of poor health policies that have affected the entire system of health. 

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