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4. The hand-picked subjects in “Sick” don’t reflect the full range of causes for so much poor health in this country, many of them rooted in inertia: not watching one’s diet or exercising, drinking to excess, smoking. Cohn’s victims are in almost every instance hardworking, conscientious people blocked at every turn by a dysfunctional system. Thus, even as he vividly brings them to life, Cohn cautions that their stories “are not so much representative as indicative,” meant to show the perils faced by people “when their need for medical care overwhelms their ability to pay for it.” But “Sick” is much more than a meticulously drawn and moving compilation of crises. It is also an edifying primer on how we got here. To fine effect, the author weaves summaries of health care history into the case studies. He traces the developmental arcs of key institutions, like private insurance, employer-linked insurance, managed care, religious hospitals and corporate health care. We see Blue Cross and the first prepaid group practice in the bloom of their youth when idealism was high and implementation relatively straightforward. They flourish for a while but then decline under the weight of a troubled manufacturing economy, bottom-line imperatives of corporate health care, the rising cost of medical technologies and changing definitions of what constitutes basic benefits.

   Cohn also reminds us that efforts to enact a national health policy have been a staple of presidential politics in the past century. In the 1930s Franklin D. Roosevelt wanted to pursue a universal health insurance plan (as Theodore Roosevelt had done during his failed presidential bid in 1912, although Cohn doesn’t mention it) but feared opposition from the American Medical Association and from state medical societies. Harry S. Truman had the same idea, only to meet resistance from union leaders concerned that members’ benefits would decrease under a national system. A quarter-century later, President Nixon proposed an employer mandate to insure workers, and in the early 1990s we lived through the drama (and trauma) of President Clinton’s thwarted reform effort.

   “Sick” does not offer a prescription for our ailing health care system, but it does include a closing chapter on what to do. Here the argument turns tendentious. Critics of universal coverage, Cohn writes, often traffic in alarmist tales “about rationing and waiting lines, followed by a horror story from Britain or Canada.” Those complaints are “wildly exaggerated” and also unfair, he says, because the problem is not the result of universal health care but “of universal health care on the cheap.” But Cohn is himself being unfair when he sweepingly denounces “the principles of modern conservatism” for being “conspicuously short on … comfort or hope.” In truth, there is nothing inherently pessimistic in choice, self-reliance or limited bureaucracy — the values that underlie a market-based proposal like the one introduced by Senator Ron Wyden, an Oregon Democrat. In this plan, employers would no longer provide insurance and would instead convert those costs into a bigger paycheck, enabling workers to buy private insurance from providers who would then be forced to compete for business by offering better plans. (Wyden’s proposal also offers subsidies for the unemployed.)

   Cohn prefers the French health care system, calling it the “showcase for what universal health care can achieve.” His brief description does indeed make the French model, which is largely single-payer, look attractive. But since we are not given enough details — an inevitable feature of a book that devotes only a fraction of its content to solutions — the reader is left to take the author at his word.

   Nor does Cohn fully consider fundamental questions. For example, can a health care market ever function like a regular market? Is it wiser to upend the entire system or concentrate on creating conditions that free the states to innovate on their own? Should we make private markets work better, or increase government involvement?

   It’s a pity that Cohn doesn’t adequately address these questions, because they are critical to the issue of health care reform — particularly for Americans, who historically have had a deep-seated aversion to centralization (as Truman found even among powerful unions).

   In any event, meaningful changes in health care, at least at the federal level, will surely follow the incrementalism that marked policy changes in the Clinton years. Of course, incrementalism, too, can lead to a health care revolution. And Cohn’s important book may bring us closer to that day.

   Sally Satel, a physician, is a resident scholar at the American Enterprise Institute and co-author of “One Nation Under Therapy.”

5. Per its title, documentarist Lorna Green’s nonfiction work Bloodletting: Life, Death and Healthcare constitutes a meditation on institutionalized health care. Green conducts her investigation in two geographic spheres: she begins by leading a team of U.S. health care experts to Cuba, with the goal of documenting cinematically the assets and liabilities of the Cuban health care system – and thus raising the question of whether an island nation of low economic stature can provide adequate care for its citizens. In the second half of the film, Green returns to the U.S., camera in tow, and documents her own family’s struggle to obtain adequate medical care without insurance. Her mother (who works as a teacher) and her brother (who works in manufacturing) experience such rudimentary complications as an asthma attack and a root canal, and find themselves sinking rapidly into a quicksand of debt. Green’s film thus becomes an intensely personal story about the consequences and costs of privatized health care for average American citizens. ~ Nathan Southern, All Movie Guide

6. Welcome to The Carpetbagger

   Melena Ryzik is your guide on the red carpet to the news and the nonsense of awards season, covering the Golden Globes, the Oscars and more. The Carpetbagger — joined by Michael Cieply, Brooks Barnes and Rebecca Cathcart in Los Angeles, and Paula Schwartz in New York — will take a look at films and the people who make and star in them, business trends, technical breakthroughs and interesting moves by the moguls. Tips are always welcome.

   Girl crush alert! Maggie Gyllenhaal is meant to be the thinking woman’s sex symbol, a smart heartthrob for the indie set (and possibly, thanks to her breakthrough role in “Secretary,” the S&M set). Ms. Gyllenhaal stars alongside Jeff Bridges in “Crazy Heart,” playing Jean, the young journalist and single mother who has a life-changing affair with his down-and-out country singer, Bad Blake, who is twice her age. Though he’s received the lion’s share of praise – A.O. Scott called it “a small movie perfectly scaled to the big performance at its center” – and earned Mr. Bridges Oscar frontrunner status, Ms. Gyllenhaal’s role in many ways requires just as deft a touch. Her character is vulnerable but tough, appealing but misguided. It’s a quiet, nuanced part that she makes sexy and personal and real.
   I didn’t know why I took it at the time. Usually when I find a movie or a part that appeals to me, I know immediately, I get this kind of pull towards it, like O.K. I have to do this and I don’t know why. I think in retrospect, when I made the movie, I had an almost two-year-old and I started to have that feeling that I think a lot of mothers have, probably intermittently throughout being parents, but it’s the first time I had, that even though I had made ‘Batman’ and a couple of things, I had been almost completely focused on my daughter, for almost two years. I got this kind of intense feeling of, ‘I need to do something for me.’ I’m also a woman, I’m also an actress, I need something for me, and the movie was that. And I think it probably had a lot to do with the fact that I was playing her, but I think that’s what happens with her, you know that she’s kind of in an emergency state of that feeling. She’s been taking care of a four-year-old by herself, and I think pulled herself out of something really hard, and she desperately needs something for her. And I think she doesn’t care if it’s bad for her, I think it’s better if it’s bad for her. As long as it feels good.

   So the Bagger had lunch with Ms. Gyllenhaal in a neighborhood restaurant in Brooklyn recently to talk about the film and awards season; Ms. Gyllenhaal is doing double-duty this year, campaigning for “Crazy Heart” and rooting for “An Education,” which stars her husband, Peter Sarsgaard. Over a couple of shared salads, the conversation meandered from typical local-girl topics – food, dating, real estate – to the nuts-and-bolts of indie filmmaking and distribution, in which Ms. Gyllenhaal has become an expert by necessity. The Bagger left thoroughly impressed and even more enamored, so much so that this conversation will run in two parts.

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