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

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

by Elisabeth Rosenthal


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New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 

"This book will serve as 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, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems.

In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast?

Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. 

The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.

Product Details

ISBN-13: 9780143110859
Publisher: Penguin Publishing Group
Publication date: 03/13/2018
Edition description: Reprint
Pages: 432
Sales rank: 46,754
Product dimensions: 5.40(w) x 8.20(h) x 1.10(d)

About the Author

Dr. Elisabeth Rosenthal was for twenty-two years a reporter, correspondent, and senior writer at The New York Times before becoming the editor in chief of Kaiser Health News, an independent journalism newsroom focusing on health and health policy. She holds an MD from Harvard Medical School, trained in internal medicine, and has worked as an ER physician. She lives in New York City and Washington, DC.

Table of Contents

Introduction Complaint: Unaffordable Healthcare 1

Part I History of the Present Illness and Review of Systems

1 The Age of Insurance 11

2 The Age of Hospitals 22

3 The Age of Physicians 55

4 The Age of Pharmaceuticals 87

5 The Age of Medical Devices 128

6 The Age of Testing and Ancillary Services 148

7 The Age of Contractors: Billing, Coding, Collections, and New Medical Businesses 166

8 The Age of Research and Good Works for Profit: The Perversion of a Noble Enterprise 182

9 The Age of Conglomerates 205

10 The Age of Healthcare as Pure Business 223

11 The Age of the Affordable Care Act (ACA) 230

Part II Diagnosis and Treatment: Prescriptions for Taking Back our Healthcare

12 The High Price of Patient Complacency 241

13 Doctors' Bills 248

14 Hospital Bills 261

15 Insurance Costs 280

16 Drug and Medical Device Costs 302

17 Bills for Tests and Ancillary Services 319

18 Better Healthcare in a Digital Age 321

Epilogue 328

Afterword 331

Acknowledgments 339

Appendix A Pricing/Shopping Tools 343

Appendix B Tools for Vetting Hospitals 346

Appendix C Glossary for Medical Bills and Explanations of Benefits 348

Appendix D Tools to Help You Figure Out Whether a Test or a Procedure Is Really Necessary 352

Appendix E Templates for Protest Letters 354

Notes 357

Index 401

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