The Good Nurse: A True Story of Medicine, Madness, and Murder

In the US, the setting for the biography A Good Nurse, there are two different types of healthcare: private and public. Public healthcare is provided by the government through a national healthcare system, such as Medicaid and the Veterans Administration, whereas private healthcare is provided through companies or organizations. These are sometimes “for profit,” meaning that they intend to make money off the services they provide, while others are “not for profit,” like faith-based organizations. Insurance companies and institutions can fall into the category of either public or private healthcare.

A long-standing argument in favor of a privatized healthcare system is the “free market” ideology, which is a broader capitalistic ideation stating that competitive institutions allow for better access, lower costs, and higher quality of health care. However, many critics have noted that privatized healthcare systems result in increased costs (such as insurance premiums), more bureaucracy (as people struggle to advocate for the services they need), and less efficiency. Studies conducted on for-profit nursing homes have found that the quality of care is significantly worse than not-for-profit alternatives, and emergency medical systems that are privatized highlight decreased quality of care and slower response times (“The Case Against Privatization of U.S. Healthcare,” Physicians for a National Health Program. 2018.).

Charles “Charlie” Cullen’s ability to commit so many crimes is grounded in privatized healthcare. Repeatedly, hospitals prioritize their reputations and put minimal effort into investigations. They let Charlie go because they suspect that he’s guilty of a crime, not because they’ve confirmed that information or presented it to the police. Because they don’t seek proof, Charlie can even attain neutral recommendations from his past hospitals. This means that they confirm his employment; some even go so far as to praise him. The lack of nursing practitioners in his geographic area means that he can easily get job after job, driven in part by the need generated from the private sector.