An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

An American Sickness is an excellent synopsis of how we got to where we are with healthcare in the United States. Healthcare has gradually become a $3 trillion business that has shifted from affordable care for Americans to healthcare dictated by profit models that were previously only seen in America’s largest corporations. Elisabeth Rosenthal, an M.D. herself, takes a bipartisan approach in placing the blame squarely on members of both parties as they have been the benefactors of the largest lobbying group in the United States: healthcare. Members of both parties have been allowing the travesty of out of control healthcare costs to rise in the United States while other developed nations, with similar and often better care, have healthcare costs significantly lower in comparison. This book will make you appreciate the good intentions of the Affordable Care Act (ACA), with many of these intentions defeated by powerful lobbying groups from not only the medical insurance lobby but the hospital, pharmaceutical, and medical device lobbies as well. If you believe that repealing the ACA or Obamacare is the answer then you may possibly gain another perspective upon reading this book. The growing costs of healthcare in America is a problem that Americans are increasingly becoming burdened with and the answer is government intervention against those who espouse “free markets” in the healthcare industry, which has directly led to the rising costs of healthcare. Rosenthal lists the principles of the current “dysfunctional medical market” which is what drives the narrative of her excellent book: 1. More treatment is always better. Default to the most expensive treatment. 2. A lifetime of treatment is preferable to a cure. 3. Amenities and marketing matter more than good care. 4. As technologies age, prices go up rather than fall. 5. There is no free choice. Patients are stuck. And they’re stuck buying American. 6. More competition vying for business doesn’t mean better prices. It can drive prices up, not down. 7. Economies of scale don’t translate to lower prices. With their market power, big providers can simply demand more. 8. There is no such thing as a fixed price for a procedure or test. And the uninsured pay the highest prices of all. 9. There are no standards for billing. There’s money to be made in billing for anything and everything. 10. Prices will rise to whatever the market will bear.

American Sickness by Elisabeth Rosenthal is an exhaustive, detailed look at the American healthcare system. The author examines every facet of healthcare, going back to the beginning in order to understand how we have gotten to where we are. If there is one overriding theme that one could point to as the cause of skyrocketing healthcare costs, it is greed. Our healthcare system has morphed from a patient-centric system to one where profits come before patient care. The first half of the book is a history lesson. What were things like before there was health insurance? When did things change from a need to protect people to one where maximizing profits became the primary goal? Along the way, the author uses real-world examples culled from actual patient bills to illustrate just how out-of-control things have become. The second half of the book looks at what needs to happen in order to gain control of costs. The author offers a wide array of solutions. The first step is to be more proactive with your own healthcare. Ask questions. Challenge unethical practices. One example the author gives is a patient who is visited by an anesthesiologist. The anesthesiologist stops by the patient's hospital room. "How are you doing?" "Fine, thanks."Okay, let me know if you have any questions?" The anesthesiologist leaves and the patient finds out later that he or she was charged a $500 consultation fee. The second step in controlling costs is government intervention. There are going to be a lot of people who are going to argue against this. The government shouldn't be in control of my health. Regulations hamper innovation. The truth is that the benefits of sensible government intervention and regulations far outweigh any negatives. For example, a government-controlled fee schedule would prevent wide disparity in charges for the same procedure. A national health database would allow patients to have their health records stored in a single location, accessible to healthcare providers anywhere, eliminating duplicate and unnecessary tests. Many of the problems we have today are the direct result of politicians bending to the demands of political donors over the interests of their constituents. What about the Affordable Care Act? The author calls it a good first step. Unfortunately, Republican opposition and efforts by industry PACS have weakened its effectiveness. There are hundreds of examples of outrageous charges and bills from actual patients. One that stood out for me involved a plastic surgeon who charged $50,000 for three stitches in a toddlers face. The parents of the child not only complained to the hospital, the doctor, and to their insurance company, but they also sent a copy of their complaint to a plastic surgeon professional group. The pressure from the complaint eventually led to a final bill of $5,000. This is one book where I listened rather than read. The deluge of facts and figures were easier to consume. I highly recommend this book. I especially recommend this book to the regulators and healthcare professionals who are in the best position to make the changes needed.

... but it will make you a better patient and advocate. Very informative and thought provoking discussion about the US healthcare industry facilitated by a physician and journalist. Individual anecdotes help explore the tangible consequences of boughten policy, uninformed regulation and stagnation in our current healthcare system. The individual stories also help the reader to grasp the more formal and abstract data references. The author provides great counter points to much of her commentary and recommendations, giving a nicely balanced consideration of the topics. The language and pace of the book makes it an approachable and enjoyable read. I would have enjoyed a deeper dive into some of the topics, such as tort reform and private practice reimbursement. That being said the book hits the mark for its larger audience. Acceptionally useful reference material in the appendices for patients and healthcare professionals alike.

Insightful details. Problems in the healthcare system have been oulined very well

An excellent overview of a health system that, like the Curate's egg, is good in parts, and shocking bad in others. Written in non-technical language, the text shows in great detail how the US health care system was 'captured' by vested interests to the detriment of middle and working class Americans. It also examines the limitations of 'Obamacare', showing how the Republican majority in Congress weakened and diluted Obama's health care reforms. The final part of the text is a handbook an how the consumers of health care can agitate and lobby for a fairer health care system, one that does not threaten families with bankruptcy from health bills. A good read.

This book is the foundation of all healthcare systems and showcases the issues and impacts from the US to worldwide! a must read!

This is as strong a critique of American medicine as I have read.

This book does not have a systematic introduction on the US healthcare system. So you may not be able to get a big picture on the system. But the stories of individual patients who suffered in this system, the author's reflections on the problems of the system and genuine suggestions on how to protect and voice yourself as a patient in this system are very informative and helpful!!! Strong recommendations!! Great book!