My first Jack Reacher novel. Action and strategy prevail as Jack takes a very vulnerable older couple under wing. They owe the Albanians (or the Ukrainians?) big time, and Jack does not fail. But. The other menace in this novel is the medical consortium that works on a cash only basis, even when need is great and providers are obliged to go to loan sharks. So I expected clever Jack to address that issue, but alas. So many feats of marvelous timing and mental chess occur I was reminded of the old Doc Savage comics, where the multi talented hero could defeat all odds, no matter the circumstance. I listened to most of it on CD, and was riveted up the last part, where the insane amount of dead bodies piled up by Jack and his cohorts became unbelievable in reason and possibility. What of those families left behind to become welfare responsibility and the children left twisting in the wind? As a plot /action driven book it does not disappoint, but though the problems are resolved, the source and cause are not.