“The Cost of Care: How Four Nurses Put Patients First in a Profit-Driven System” by Theresa Brown

c.2026, Algonquin Books, $30, 256 pages

Watch for falling stars.

Blow dandelion seeds or an eyelash from your cheek and see what happens. Cross your fingers, make a wish. Get the bigger side of the turkey bone this Thanksgiving. Knock on wood, toss a penny in a fountain, these are the ways to want a better outcome. Or read “The Cost of Care” by Theresa Brown, and hope.

Hope, says Brown, is what she was looking for when she started researching her book.

As it was for many medical professionals, the COVID epidemic had been brutal and she felt “burned up” after the worst was over. She was shaken by what she’d seen, and by what she could see coming to medical facilities and patients’ homes across America.

She needed some good news.

Her first stop was in Pittsburgh, Pa., at The Midwife Center, a facility that primarily serves women with low-risk pregnancies who are on Medicaid. The Center doesn’t insist on immediate IVs for laboring mothers, nor do they offer epidurals or automatic episiotomies; they safely treat labor and delivery not as a medical event, but as one that’s natural and normal. The Midwife Center, says Brown, runs on a tight budget but it, like all the places she visited here, saves patients and taxpayers money.

In Portland, Ore., she found Housecall Providers, an in-home primary care organization that sends an entire team of nurses and social workers out to people who are unable, often due to poverty or mental illness, to leave their homes. Brown followed nurses working with the CAPABLE (Community Aging in Place, Advancing Better Living for Elders) program, which included a handyman; she shadowed a palliative care nurse in a mid-sized Midwestern city; and she visited Connecticut Hospice.

America is the wealthiest nation on Earth, Brown points out, but our life expectancy is lower than, and our maternal mortality is higher than, that of economically similar countries. Our health care can’t compare and, says Brown, we should do better.

In today’s economy, it seems that we’re all asked to do more with less. In the nursing world, as Brown shows, that can mean creativity, thinking outside the proverbial box, teamwork and comforting resourcefulness.

On that, you’ll be hard-pressed to find a more compassionate, grace-filled book than “The Cost of Care.” Here, Brown lauds the medical pros she knows before honing in on four places she thought would offer her the hope she sought, perceiving them somewhat as encouraging oases in the midst of profit-driven medical care.

She doesn’t disappoint in her choices. The facilities she studied found ways to offer stellar care in tax-saving, deductible-saving, lifesaving ways through workarounds, grants, donations and unique programs that work. She then goes further, reminding readers that health care can be this way everywhere. It’ll just take the right kind of work.

Readers who are facing a big hospital bill will want this book, as will medical professionals, politicians and hospital administrators. If you’re concerned about health care in America, “The Cost of Care” is a five-star read.

Want more? Try “The Age of Cures: How American Scientists Saved Your Life” by Barry Werth (Simon & Schuster, $32), a book about medical research, medical triumphs, and the people responsible for them.