The Midnight Stranglers: A Book Review

Over the years, I’ve witnessed countless stories about patients with obstructive sleep apnea who undergo nightmare experiences while undergoing treatment. Oftentimes, the insurance issues can be worse than any medical issues. In his book, The Midnight Stranglers: A Personal Quest For Healthcare Transparency, Aiden Hill chronicles his painful journey from first being diagnosed with obstructive sleep apnea to his ordeal as a consultant helping California residents obtain health care coverage. 

 
Mr. Hill first discovers that he has obstructive sleep apnea after gaining significant weight just after undergoing a knee operation. After going through the routine steps that are taken (sleep study, CPAP, dental appliance), he was still not sleeping better. He hit his first major roadblock when his insurance company refused to cover his oral appliance. This was the beginning of a long journey detailing his challenges in finding alternative options and finally settling on successful jaw surgery. He chronicles in very fine detail every insurance denial, delay tactic, double standard and other outrageous, but standard practices in the insurance industry. He also gives a scathing account of how our health care system encourages this, and spreads the blame to patients, the insurance industry, doctors and government alike. 
 
The second part of his book describes his frustrations while helping to launch California’s version of Obamacare (Covered California). Although none of the insurance maneuvering and health care system failures are anything new, his biting commentaries and liberal use of literary analogies kept the pace moving and read almost like a John Grisham novel. Though starting out very optimistic, he ends on a somewhat pessimistic view of health care reform in America. He finishes by coming back full circle on a conciliatory, but optimistic tone, recommending practical solutions for health care reform, as well as a heart-felt apology to those who were hurt along his quest for healthcare transparency.
 
Here are 5 points that came to mind while I was reading:
 
  1. Basic concepts of obstructive sleep apnea and consequence of non-treatment are covered. It’s not taken to be medical advice, but is well-written from a lay-person’s perspective. 
  2. He describes the current flawed state of affairs with our health care system, likening it to Dr. Jekyll and Mr. Hyde. There can be a dark consequence to any good intention. 
  3. With ongoing changes to our health care system, he emphasizes the importance of taking a pro-active approach before undergoing any type of treatment. Even then, you’re likely to get hit with an unexpected bill, despite putting in your due diligence. Expect to spend hours, days or even years dealing with the aftermath. I’ve experienced this personally numerous times.
  4. The problems that he encountered with insurances companies, doctors, hospitals, and government entities are all governed by the basic rule: “Protect the asset.” 
  5. I completely agree that full financial transparency is needed before undergoing any medical transaction.
 
This book is a must read for anyone recently diagnosed with obstructive sleep apnea. There are many books by medical experts on how to deal with a new sleep apnea diagnosis, but Hill’s perspective as a patient provides valuable insights into the complex and prolonged process towards ultimate wellness. This book is a candid narrative of one such person’s journey.
 
I finished reading this book during a flight from NY to CA. Fortunately, the depressing tone of the book was tempered by the excitement and hope that I felt after hearing the speakers at the Airway Dentistry conference. Granted, he could have written a similar book if he had cancer or some other chronic condition. However, his story helped me to better understand what my patients must face, and ultimately, it will help me to better help my patients. 

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One thought on “The Midnight Stranglers: A Book Review

  1. I starting receiving acupuncture last year, luckily my insurance covered my treatments for months until they decided not to. At first they were refusing to pay my acupuncturist but after contesting it, they did.
    My accupuncturist told me a story of a woman with chronic back problems. Acupuncture was working very well. Her insurance changed and they said they would no longer pay for her treatments. The insurance agent she spoke with advised her to just get back surgery. The insurers would rather pay for an expensive surgery than pay for her weekly, basically non invasive treatments, which worked well for her.

    This makes no sense to me.