How U.S. Health Care Became Big Business

The stream health caring complement focuses too mostly on financial incentives over health or science, says Elisabeth Rosenthal in her new book, An American Sickness.

The stream health caring complement focuses too mostly on financial incentives over health or science, says Elisabeth Rosenthal in her new book, An American Sickness.

Health caring is a trillion-dollar attention in America, though are we removing what we compensate for? Dr. Elisabeth Rosenthal, a medical publisher who before worked as a medical doctor, warns that a existent complement too mostly focuses on financial incentives over health or science.

“We’ve devoted a lot of a health caring to for-profit businesses and it’s their job, frankly, to make profit,” Rosenthal says. “You can’t design them to act like Mother Teresas.”

Big California Firms Take On Health Care Giant Over Cost of Care

Rosenthal’s new book, An American Sickness, examines a deeply secure problems of a existent health-care complement and also offers suggestions for a approach forward. She annals that underneath a stream system, it’s distant some-more remunerative to yield a lifetime of treatments than a cure.

“One consultant in a book joked to me … that if we relied on a stream medical marketplace to understanding with polio, we would never have a polio vaccine,” Rosenthal says. “Instead we would have iron lungs in 7 colors with iPhone apps.”

Interview Highlights

On what converging of hospitals is doing to a cost of caring

In a beginning, this was a good idea: Hospitals came together to share efficiencies. You didn’t need each sanatorium grouping bed sheets. You didn’t need each sanatorium doing each procedure. You could share annals of patients so a studious could go to a medical core that was many appropriate.

Now that converging trend has kind of snowballed and skyrocketed to a indicate … that in many tools of a country, vital cities usually have one, maybe two, sanatorium systems. And what we see with that turn of converging is it’s kind of a mini-monopoly.

'Paying Till It Hurts': Why American Health Care Is So Pricey

What happens, of course, when we have a mini-monopoly is we have an huge lean over price. And so, what we see in investigate over and over again is that a cities that have a many sanatorium converging tend to have a top prices for health caring though any advantage for studious results. So consolidation, that started as a good thought in many places, has developed to a indicate where it’s not benefiting patients anymore, it is benefiting profits.

An American Sickness

An American Sickness

How Healthcare Became Big Business and How You Can Take It Back

by Elisabeth Rosenthal

Hardcover, 406 pages |


On a ways a health-care attention stands to distinction some-more from lifetime diagnosis than it does from restorative disease

If you’re a curative manufacturer and we have a problem like diabetes, for example, if we invented a tablet tomorrow that would heal diabetes — that would kill a multi-billion dollar business market. It’s distant improved to have treatments, infrequently unequivocally good treatments … [that] go on for life. That’s many improved than something that will make a illness go divided overnight.

On how prices will arise to whatever a marketplace will bear

Another judgment that we consider is singular to medicine is what economists call “sticky pricing,” that is a smashing term. It fundamentally means … once one drugmaker, one hospital, one alloy says “Hey we could assign $10,000 for that procession or that medicine.” Maybe it was $5,000 dual months ago, though once everybody sees that someone’s removing divided with charging $10,000, a prices all go adult to that gummy ceiling. …

What we see mostly now is when general drugs come out … a cost doesn’t go down to 20 percent of a branded price, it maybe goes down to 90 percent of a branded price. So we’re not removing what we should get from a unequivocally rival marketplace where we, a consumers, are creation those choices.

On initiating conversations early on with doctors about fees and medical bills

You should start each review with a doctor’s bureau by seeking “Is there a concierge fee? Are they dependent with a hospital? Which sanatorium are they dependent with? Is a bureau deliberate partial of a hospital?” In that box you’re going to be confronting sanatorium fees in further to your doctor’s bureau fees. You ask your alloy always … “If we need a lab test, if we need an X-ray, will we send me to an in-network provider so we don’t get strike by out-of-network fees?” …

Medical Bills Still Take A Big Toll, Even With Insurance

Often that will be a small tough for your doctor, since they competence have to fill out a opposite requisition, though it’s value asking. And any alloy who won’t assistance we in that way, we think, isn’t attuned to a financial cost that we’re temperament today.

On removing charged for “drive-by doctors” brought in by a sanatorium or primary doctor

You do have to contend “Who are you? Who called you?” and “Am we going to be billed for this?” And it’s comfortless that in liberation people have to consider in this kind of keep-on-your-guard, rather adversarial way, though we consider if we don’t pull behind opposite a complement in a approach it bills, we’re complicit in permitting it to continue.

On how to interpret coded medical bills

Don’t be dumbfounded by a “prompt remuneration discount.” Go behind to a sanatorium and say, “I wish a entirely itemized bill. we wish to know what I’m profitable for.” Some of it will be in codes, some of it will be in medical abbreviations. I’ve detected we can Google those codes and find out what you’re being charged for, often, and many importantly, we competence find you’re being charged for things that apparently we know we didn’t have.

Elizabeth Rosenthal is editor-in-chief of Kaiser Health News, an editorially eccentric news module of a Henry J. Kaiser Family Foundation and a partner of NPR’s. Neither KFF nor KHN is dependent with Kaiser Permanente. Radio writer Sam Briger and web producers Bridget Bentz and Molly Seavy-Nesper contributed to this story.