So much for that. Lionel Shriver. 2010.

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All his life Shep Knacker has dreamed of leaving New York and living in simplicity in the Third World. Yet he comes to realise that his wife, Glynis, has never been serious about making the change. On the very day that he announces he is leaving for the island of Pemba with or without her, she informs him that she is gravely ill.

So he can’t leave. If nothing else, Glynis needs his health insurance. But despite their having insurance coverage, the co-payments required for her astronomically expensive treatments systematically deplete Sharpe’s nest egg, and this once well-off small businessman hurtles towards bankruptcy.