To Our Readers

By ELIZABETH VALK LONG President

For the Washington politicians who are struggling with the issue, health care often seems to be about arcane terms like mandate, cherry picking, adverse selection. For associate editor Janice Castro, health care is about babies being born, illnesses being treated and the security of being expertly cared for by your doctors and nurses. But Castro, who has covered health policy for TIME since 1984, knows that in order for Americans to take an intelligent part in the national debate over reforming the health-care system, they must understand those arcane words.

The ability to reconcile the human and practical aspects of health care with the technical details is what distinguishes Castro's story this week on doctors and managed-care networks. "Everyone in health care talks in an indecipherable language," she says. "What, for example, is a 'preferred provider'? You might think it's a very good doctor, but it isn't. It's the one insurers will pay for, the one you have to go to."

Castro's passion for explaining health care in clear, illuminating language recently led her to write a book on the subject -- The American Way of Health: How Medicine Is Changing and What It Means to You, published in May in both hardcover and paperback by Little, Brown. She spent six months crisscrossing the country -- from Walnut Creek, California, to Leesburg, Virginia -- interviewing patients, nurses, insurance executives, Senators -- just about anyone with a voice or a stake in the decisions that Washington soon hopes to make. She talked to AIDS patients at San Francisco General and stood at the elbow of Dr. Wayne Isom as he performed open-heart surgery at New York Hospital.

"I learned there are a lot of good, dedicated people in medicine," she says, "but there's also a lot of money at stake in the debate over reform. Health care is a zero-sum game. Every dollar we waste on something someone doesn't need is a dollar we don't have for a patient who needs help."

Castro draws on personal experience in the book as well. Her father's stroke in 1991 confronted her with a bureaucracy that made cost, not wellness, the basis for his hospital release. Not until he realized that his recovery depended on himself and not the white coats he had so believed in all his life did her father improve. He finished reading Janice's book just before he died in May, at 79. "I get calls from doctors who have read that chapter who comment what a brave and determined man my father must have been," she says.