Jim Bailey's The End of Healing is a fascinating book, but it is not really a novel. Bailey uses the form of a novel to do info dumps about the problems of the American medical system, and why we have them.

We in the USA have by far the most expensive medical system in the world -- and yet we rank 37th in positive results. This book describes why and how that happens.

And those parts of the book are fascinating and engaging. I'd known some of this before, but Bailey offers a devastating and succinct exploration of all the various aspects, and how they lead to extremely expensive yet perverse incentives and results.

That aspect is thorough and sobering.

The "novel" aspects, though, are not great.

The "evocative" prose about the landscapes, etc., is overwrought and uses probably twice as many adjectives as it needs.

All the characters are ciphers, even our protagonist, Don/Dante, who is filled with angst and agonizing that is only resolved right at the end, for no special reason. His biracial status combined with his passing for white adds to his angst but has no appreciable effect on the plot, which is reasonable enough ... but then why all the prose documenting it if it's irrelevant?

The women are awful, especially the young ones. Frances, the one most present, is entirely arbitrary, and her breakup with Don makes pretty much no sense, though it advances the plot somewhat. (In fact, I was rather hoping that the foreshadowing implied that she was trans, but that was not the case.) Talk about the perfect woman! Smart, gorgeous, stacked, but with a NURSING degree so she doesn't challenge the menfolks, who are DOCTORS. And, willing to put her energy behind whatever her dude of the moment favors....

Anyway, as a novel, it's bad. Very bad.

However, as a concentrated way of learning about how the medical industry is a horrible mess and how it got to this state, it's compelling and thorough. I wish the author had written a series of essays rather than trying to make this a "story."

This is recommended for people who don't mind long books and who are fascinated by how badly our medical system has gone awry.