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The New York Times bestseller.
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.
“Patients can save thousands of dollars by purchasing An American Sickness by Elisabeth Rosenthal.”— New York Journal of Books
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.
- Sales Rank: #508 in Books
- Published on: 2017-04-11
- Released on: 2017-04-11
- Original language: English
- Number of items: 1
- Dimensions: 9.56" h x 1.26" w x 6.44" l, 1.25 pounds
- Binding: Hardcover
- 416 pages
Review
“An eye opening discussion . . . [An] important book. . . . Rosenthal told an interviewer her goal was to “start a very loud conversation” that will be “difficult politically to ignore.” We need such a conversation – not just about how the market fails, but about how we can change the political realities that stand in the way of fixing it.”— The New York Times Book Review
“Patients can save thousands of dollars by purchasing An American Sickness by Elisabeth Rosenthal.”— New York Journal of Books
"An authoritative account of the distorted financial incentives that drive medical care in the United States . . . Every lawmaker and administration official should pick up a copy of An American Sickness. Then, at last, the serious debate could begin.” -The Washington Post
“Bold, insightful, well-researched analysis.” — Nature
“In this in-depth analysis of a malfunctioning system, Rosenthal makes a compelling case against the hospital and pharmaceutical executives behind the “money chase,” and it’s hard to imagine a more educated, credible guide…The patients she interviewed share mind-boggling stories…She builds her case with one damning statistic after another…Rosenthal presents solutions both personal and societal in this commanding and necessary call to arms.”
—Booklist (starred)
“Provocatively analyzes...Rosenthal unveils with surgical precision the "dysfunctional medical market"...a startling cascade.”
—Publishers Weekly (starred review)
“A blast across the bow of the entire health care industry . . . Throughout, the author blends extensive research with human interest . . .A scathing denouncement.”
—Kirkus Reviews
“Elisabeth Rosenthal’s meticulous history of the crisis in American health care should be required reading for our generation. I have not read another volume that diagnoses the “deeply, perhaps fatally, flawed” system of health insurance and delivery with such lucidity, dissects its critical shortcomings, and provides such a clear prescription for its ills. Bold, imaginative, tautly written and filled with fury and compassion, 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
“Dr. Elisabeth Rosenthal, a physician turned tenacious reporter, shows how the ‘highly dysfunctional’ American health care system turned the Gentle Art of Healing into a Greedy Arsenal of Profit, where everybody does well—except the patient. She also teaches us how to fight back against useless treatments, outrageous fees, and bewildering bills.”
—T. R. Reid, bestselling author of A Fine Mess, The Healing of America, The United States of Europe, The Chip, and Confucius Lives Next Door
“An American Sickness will give you many new reasons to avoid getting sick, but also the resources to help protect your finances and your life if you do. Elisabeth Rosenthal’s remarkable, outrage-inducing book reveals how each attempt to check the health industry’s excesses has been exploited for monetary gain. Both a fascinating history of dysfunction, and a clear manifesto for change.”
—Sheri Fink, M.D., Ph.D., Pulitzer Prize-winning author of Five Days at Memorial and War Hospital
“Through vivid, heart wrenching stories and trenchant analysis, Libby Rosenthal unveils the irrationality, indifference, harmfulness, and downright unfairness of the American health care system that can often seem more driven by profit than caring and compassion. She also offers tremendously helpful advice to patients on how to navigate the system to ensure they get the best outcomes.”
—Ezekiel J. Emanuel, M.D., Ph.D., Chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and author of Reinventing American Health Care
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.
Most helpful customer reviews
109 of 111 people found the following review helpful.
A Genuine Public Service
By David Wineberg
An American Sickness is a gripping, fast paced and revolting dive from 50,000 feet above into the morass of what passes for healthcare in the USA. Patients are barely tolerated in a system optimized to pass money from bank accounts to providers. The industry is mean, nasty and greedy, with worse results than comparable nations - for far more cost. Everything you feared is true, and there is much more in these 400 pages.
Because Rosenthal (an MD herself) was a columnist for the New York Times, she received thousands of contacts over the years. She researched them and they provide the vivid and shameful examples of financial abuse in the industry (with real names). She has distilled them into a perverse list of principles of US healthcare that explains everything and forms the backbone of the 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.
As the American economy freefalls into dysfunction, doctors and nurses have become “independent contractors”, just like everyone else. They must look out for themselves first. Administrators are no longer senior caregivers but numbers people who must limit the poorly insured and maximize the profit on every square foot.
What becomes obvious is that the “market” system has failed utterly and completely. Health cannot be left to capitalists, be they doctors, hospitals or manufacturers. The rest of the western world and history are the proof: “If the March of Dimes was operating according to today’s foundation models, we’d have iron lungs in five different colors controlled by iPhone apps – but we wouldn’t have a cheap polio vaccine,” Rosenthal quotes Dr. Michael Brownlee. The incentives are all wrong.
An American Sickness is a public service. It gathers, for the first time I know of, the various scams used by the professions to jack up bills. It explains the why and the how of all those bills being so high. It is well organized, clear and it puts everything into perspective as part of a greater scheme. It identifies what to look out for, what to ask, and how to skirt the event horizon. Rosenthal provides really useful links and sample letters, because customers are all in this same situation – ignorant and powerless. I particularly like her examination of prices for the same procedures around the world. You can afford to have treatments elsewhere, because the costs are so much less, that you can throw in the travel – for two – and still come out well ahead. This book is worth far more than a month’s health insurance; it can save you a fortune, and give you back your life.
David Wineberg
11 of 11 people found the following review helpful.
I teach health policy and am amazed at what I didn't know about the way our ...
By Whitney
I have been a nurse since 1978 and have had a front row seat to the changes in health care in the ensuing decades. I teach health policy and am amazed at what I didn't know about the way our health care system is financed. It is appalling. You should be scared. You should read this book and work for change.
23 of 25 people found the following review helpful.
How healthcare got this way
By D. McLeod AZ
Not a subject matter I would normally be interested in, but in the current political climate I felt I should get a better understanding of what is going on in the healthcare industries. The four chapters on the history of the American heath insurance industry, hospitals, doctors and pharmaceutical industry alone make the book worthwhile to read.
I am not a big fan of the government getting involved in healthcare, however if we are going to let free enterprise control the costs I think it is important to know if the healthcare industries will respond to true competition like other industries such as the telecommunication and automotive industries. This book says it will not because it is functionally different. For example only 18% of hospitals are for profit. The 62% majority are nonprofit hospitals that get billions of dollars in tax breaks if they use their profits to help the poor. The government runs the other 20%. If nonprofits make too much money they just spend more. As court case after court case indicates they do not always spend those big profits to help the poor. You also learn the average of how much the pharmaceutical companies actually spend on research and development of a new drug. It is not always the billion dollar figure you hear so much about.
I am sure once conservatives learn that the author is a Harvard Medical School trained doctor that now writes for the New York Times they will discount it as biased against business and not accurate. However, the question is not the author's political leanings, but is the information correct? I have checked some, but not all, of what the author has stated and so far it checks out.
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