The American healthcare system famously spends more per person than any other system in the world, yet in outcomes, it ranks 37th. In this work, Rosenthal examines why that is the case and what practically can be done about it. Her examination operates both at levels of the patient, healthcare worker, business, insurance agency, and government/public. This book will leave you fuming that too many people are profiteering off of Americans’ health. It will also leave you better equipped to meet the challenges of tomorrow.
With such high costs yet such low results, more than one problem exists in our system. Unfortunately, politics tends to oversimplify the arguments. Rosenthal spends the first eleven chapters reviewing the historical and systemic evidence of how we got to this place. She leaves no leaf unturned in dealing with central topics like insurance, hospitals, physicians, “big pharma,” ObamaCare (the Affordable Care Act or ACA), research, and more. She illustrates how just about every element in the system has become decadent and profit-hungry. She also compares how other countries are doing a better job with much less financial investment.
After this first part of the book, Rosenthal pivots to deal with specifics of what can be done, both as individuals and as a society. This book thus has great impact both for individuals who rely heavily on healthcare and for public policymakers who want to get a leg up on the next reform. The suggestions are eminently practical and possible. Examples include avoiding hospital labs in favor of commercial lab businesses like Quest and LabCorp, negotiating national prices on drugs, offering a standard price for procedures, and pursuing antitrust legal activity against medical conglomerates.
Rosenthal, a Harvard-educated practicing MD with further training as a journalist, spares no detail in confronting this societal ill. Readers will leave with a much better understanding of the problem and future options. She even has several appendices of resources available – for challenging bills, researching prices, or undertaking social advocacy. As someone professionally invested in our healthcare system, I notice that many authors show some kind of bias; Rosenthal, however, shows none as she shines a bright light on almost every player in the system. The pro-profit orientation claims the prime space as it seems that everyone seeks to claim a monopoly on patients’ pocketbooks by holding their healthcare hostage.
This book is as comprehensive as it is erudite. Think of it as preparation for the next battle in America’s healthcare war. The new afterword, written after the failure to repeal the ACA in 2018, updates her narrative amidst new points of social discussion (or perhaps battle). An American Sickness won’t cure our problems, but it sure does shine some light on what’s going wrong and what can be done. In treatment of the problem, she does not posit over-generalized socialized medicine but merely a slew of pragmatic next steps (which can be taken or rejected individually). Overall, however, she makes clear that the spirit of gaining profit by holding patients’ health hostage needs to go. Otherwise, any new system will surely morph into something weird again. I cannot help but think Hippocrates would be proud of her work.
An American Sickness: How Healthcare Became Big Business and How You Can Take It Back
By Elisabeth Rosenthal
Copyright (c) 2018
Penguin Books
ISBN13 9780143110859
Page Count: 420
Genre: Healthcare, Public Policy
www.amazon.com