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

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

A New York Times bestseller "The definitive guide to the past and future of health care in America."--Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, a shocking investigation into the dangerous, expensive, and dysfunctional American healthcare system, as well as solutions to its myri...

Title:An American Sickness: How Healthcare Became Big Business and How You Can Take It Back
Author:
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ISBN:1524756202
Format Type:Paperback
Number of Pages:615 pages

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

  • Zack
    Apr 11, 2017

    really good write up on an overly complex system. This book is really well sourced and approachable. A lot of the content would be funny if it weren't so tragic

  • Kristin Butler
    May 05, 2017

    Doctors, Hospital employees, medical device reps, Health insurance agents anyone in Pharma should read this book. Anyone who touches medical care in any way should read this book. Anyone interested in healthcare reform should read this book.

    The nation is fixated on "Healthcare Reform" but most Americans don't seem to understand that the rising cost of healthcare has more to due with the lack of transparency in pricing and the Byzantine American healthcare chaos (system would be too generous a c

    Doctors, Hospital employees, medical device reps, Health insurance agents anyone in Pharma should read this book. Anyone who touches medical care in any way should read this book. Anyone interested in healthcare reform should read this book.

    The nation is fixated on "Healthcare Reform" but most Americans don't seem to understand that the rising cost of healthcare has more to due with the lack of transparency in pricing and the Byzantine American healthcare chaos (system would be too generous a concept), than any piece of legislation that merely addresses insurance coverage.

    Rosenthal elucidates how the American obsession with making money has infiltrated every aspect of Healthcare ( or perhaps we should call it what it really is- sick care), bankrupting individuals across the country.

    No one is immune from Rosenthal's impeccably researched critique- hospitals, drug makers, medical device manufacturers, pharmacy benefits mangers, insurers, physicians, Democrats, Republicans. We have all created this mess and it will take a village to get out from under it.

    I have tried to explain this lack of transparency to my husband for years, but he tends to listen to talk radio and read the Wall Street Journal and it becomes a political argument with a lack of understanding regarding the complexity .

    This book helps break down the problems into each component. Compelling stories. Easy to understand.

    Read it!! Educate yourself!!

  • Marks54
    May 05, 2017

    This is an outstanding book that should be read by anyone interested in healthcare and current US healthcare debates.

    The book is not about Democrats versus Republicans or about Obamacare and various ongoing efforts to change it. The author is a physician and former NYT writer who knows much about both the practice of medicine and the business of healthcare. The point of the book is that the healthcare sector/industry has come to adopt a business model that is out to fully monetize every aspect

    This is an outstanding book that should be read by anyone interested in healthcare and current US healthcare debates.

    The book is not about Democrats versus Republicans or about Obamacare and various ongoing efforts to change it. The author is a physician and former NYT writer who knows much about both the practice of medicine and the business of healthcare. The point of the book is that the healthcare sector/industry has come to adopt a business model that is out to fully monetize every aspect of the business that is capable of being monetized. In the course of adopting this model, the practice of medicine has become detached from the business of medicine. The result of this is that patient care has become detached from business success. This business model has displaced the historical emphasis of "first do no harm" with a new emphasis of "first leave no money on the table". This is a detailed critique of healthcare business models that will no be surprising to those who have followed the sector. The shock value of the book is in the comprehensive assessment of how the "American sickness" of high cost healthcare has advanced everywhere in the US and how these trends have even accelerated in the last two decades. These forces were present before the advent of Obamacare (ACA) and will remain present after current efforts at changing the ACA have run their course and "Trumpcare" has become the new norm (whatever that will mean). We all have had inklings of how economic incentives may pervert medical decisions - for example if one get paid well to perform surgeries and less well to avoid them, one should not be surprised to find a lot of surgeries taking place. Rosenthal has written a book that shows how such economic and bureaucratic logics have come to dominate American healthcare, with highly dubious consequences for the national economy and for the health of patients.

    I will not begin to summarize or recapitulate the various arguments in the book. One way to understand them is to deconstruct what it means when someone discusses a "market" for healthcare. It is easy enough to declare that a market or marketplace approaches is at work in some way in a business. The problem is that for markets to work as intended in organizing economic transactions, there need to be a number of conditions met. If they are not met, the result will be a highly distorted arrangement and not the efficient outcome claimed by market advocates. What are those conditions? Well, there needs to be lots of competitors in a given market, or else collusion will be likely. There needs to be a relatively free flow of information among decision makers so that they have a basis for making good judgments. Participants needs to be able to move their resources around to take advantage of market opportunities. This is opposed to participants being stuck in settings and not able to respond when contracts are invalidated, prices raised without warning, etc. Sellers should also have difficulty in colluding with other sellers to control entry or prices. Participants need to be smart and informed about their situations so that they can make good decisions. There are other factors as well and these market conditions vary by industries and sectors.

    Rosenthal's critique is that the healthcare market is a very imperfect one and that as a result competitive forces do not (and likely cannot) work the way they are intended. The result is a system that accounts for over 17% of US GDP and is characterized by very high prices, lots of confusion, mixed health benefits, and significant trauma and distress for those who are poor. In one of her initial chapters Rosenthal outlines a set of rules of thumb that have developed in this highly imperfect market setting and she then proceeds to bring them up wherever relevant in later chapters. The story that results is a deeply troubling one that made me want to double check my insurance status before I read further in the book.

    Rosenthal also provides well thought out and specific options for what readers can do in the short term and what lawmakers and voters can do in the long term to counter these trends. These chapters are helpful and make the book more than just a critique. The book is also carefully annotated for those seeking to read more. The author also provides some outstanding appendices with web and other resources to consult in considering how to handle healthcare business transactions to reduce the risk of being taken for a ride.

    This is not a critique of the quality of healthcare in terms of the science. It is a call to rethink the benefits of thoughtful cost-benefit analysis so that healthcare can focus more on patient welfare and pose less of a risk to patient finances and solvency. This is only one book of many for getting up to speed with healthcare but it is a fine book to start with that I hope attains a wide audience.

  • Gerald Hilton
    May 05, 2017

    I thought I knew quite a bit about the healthcare system, because of having some chronic health issues. However, I quickly learned that my experiences were either to narrow in scope, or too old to really know our healthcare system. I knew that our system ranked as one of the worlds' worst, for providing quality healthcare to the citizens it's suppose to serve. This book not only shattered any preconceived thoughts of what I thoughts were redeeming values in the system Americans call a "healthcar

    I thought I knew quite a bit about the healthcare system, because of having some chronic health issues. However, I quickly learned that my experiences were either to narrow in scope, or too old to really know our healthcare system. I knew that our system ranked as one of the worlds' worst, for providing quality healthcare to the citizens it's suppose to serve. This book not only shattered any preconceived thoughts of what I thoughts were redeeming values in the system Americans call a "healthcare" system. It also explained why, and the many, many problems that are inherent in it.

    Therefor, I am writing this review, (something I rarely do) In hopes that many more people will read this book and not only understand how to reduce the cost of this system in their own lives. And to take any action they can politically, to make major changes for improvement.

    This book is extremely well researched and written. Using real peoples stories to bring the problems to light. As well as making it easy reading. I found this book both very enlightening and a book that I wanted to keep reading to find out what else I didn't know. As well as enraging me to know our government has shown very little concern for the basic welfare of it's citizens.

  • Steve Nolan
    May 06, 2017

    Pretty comprehensive overview of the American healthcare system. Some crazy anecdotes of people getting screwed and crazy prices for ridiculous things.

    Does a great job showing that it really isn't one single thing that's turned the whole system upside down - it's a bunch of individual parts all individually trying to maximize profits. (At the expense of people!)

  • David Marshall
    May 06, 2017

    My 80s-something mother-in-law gave me this book, because she wants her children to have the best tools available to navigate the dysfunctional American health care system. It's a excellent read, diagnosing the illness in the first two thirds of the book, and providing, if not a cure, and least a set of therapies for coping with the sickness in the last third. It dissects the interrelated disease organ by organ, the: 1) insurance companies, 2) hospitals, 3) pharmaceutical industry, 4) doctors, 5

    My 80s-something mother-in-law gave me this book, because she wants her children to have the best tools available to navigate the dysfunctional American health care system. It's a excellent read, diagnosing the illness in the first two thirds of the book, and providing, if not a cure, and least a set of therapies for coping with the sickness in the last third. It dissects the interrelated disease organ by organ, the: 1) insurance companies, 2) hospitals, 3) pharmaceutical industry, 4) doctors, 5) medical equipment manufacturers and suppliers, 6) billing companies, etc. The book is worth the price just for all the links in the reference section in the back of the book to help patients educate themselves and take action to avoid health care abuse and overcharging. Everybody who pays money for their own health care should read it, and those who don't as well. This book is truly a gem.

  • Richard Nelson
    May 25, 2017

    Untangling the Byzantine nightmare that is the American health care system is no small feat; proposing solutions is even harder. Elizabeth Rosenthal gives it a good go, though, using the traditional doctor's method: She lays out the history of the present illness (our health care is too uncoordinated and costs too damn much) and then offers a diagnosis and treatment plan. The former is better--she lays out how each sector of health care evolved into the mess it is today, in response to uniquely

    Untangling the Byzantine nightmare that is the American health care system is no small feat; proposing solutions is even harder. Elizabeth Rosenthal gives it a good go, though, using the traditional doctor's method: She lays out the history of the present illness (our health care is too uncoordinated and costs too damn much) and then offers a diagnosis and treatment plan. The former is better--she lays out how each sector of health care evolved into the mess it is today, in response to uniquely American incentive structures around profit, and while different readers might quibble with how she frames certain examples, the overall pattern she demonstrates is impossible to deny. Her solutions are less exciting, probably because they are small-ball and practical and after reading such a sprawling litany of problems, the mind craves a big solution, on the order of an immediate shift to single-payer health care with national price-setting. That ain't happening tomorrow, and Rosenthal doesn't pretend that it will, which makes the back third of the book less thrilling but probably, ultimately, more useful than it would otherwise be.

  • W. Whalin
    May 29, 2017

    A Significant Book for Every American

    Subtitled, “How Healthcare Became Big Business and How You Can Take It Back” is a new audio book and I heard it cover to cover. Elisabeth Rosenthal has an MD from Harvard but also spent 22 years as a medical reporter for the New York Times. The writing and storytelling in this book is compelling along with thorough research and multiple interviews and sources of information.

    The first section of this book tells the story of how medicine and healthcare became a

    A Significant Book for Every American

    Subtitled, “How Healthcare Became Big Business and How You Can Take It Back” is a new audio book and I heard it cover to cover. Elisabeth Rosenthal has an MD from Harvard but also spent 22 years as a medical reporter for the New York Times. The writing and storytelling in this book is compelling along with thorough research and multiple interviews and sources of information.

    The first section of this book tells the story of how medicine and healthcare became a huge business. The examples are pointed and as a reader your anxiety grows with each chapter. You learn the focus of healthcare has turned from providing excellent patient care and health to making money at the expense of the patient. With pointed and specific illustrations, you learn how the costs of healthcare have spiraled out of control—especially compared to other countries.

    The second section gives the details for every American to become proactive with their healthcare, save money and hopefully change the system. Rosenthal provides detailed information such as when you check into a hospital, there are multiple pages of release forms you sign. One of those clauses will say that you are responsible for any expenses your insurance does not cover. Rosenthal suggests you add the words “as long as the expenses are within my insurance network.” Without this addition, the patient can incur incredible personal expenses. It’s just one small example of the valuable content in this book.

    I learned a great deal from AN AMERICAN SICKNESS. The detailed websites and resources in the Appendix are a resource I plan to use over and over. I highly recommend this book.

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