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Catastrophic Care: How American Health Care Killed My Father—and How We Can Fix It
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Catastrophic Care: How American Health Care Killed My Father—and How We Can Fix It

3.9  ·  Rating Details ·  295 Ratings  ·  62 Reviews
A visionary and completely original investigation that will change the way we think about health care: how and why it is failing, why expanding insurance coverage will only make things worse, and how it can be transformed into a transparent, affordable, successful system.

In 2007, David Goldhill's father died from a series of infections acquired in a well-regarded New York
Hardcover, 384 pages
Published January 8th 2013 by Knopf (first published January 1st 2011)
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Pete Welter
Feb 27, 2013 Pete Welter rated it really liked it
The fundamental message of Catastrophic Care is that our health care spending in the US is unsustainable because free market forces are almost entirely absent from the health care industry and bureaucracy. Wherever you are the political spectrum on the health care issue, it's worth a read to make you think more deeply about the issue.

Steven Johnson introduced the term "peer progressive" in Future Perfect: The Case for Progress in a Networked Age to encompass those of us (and I find myself in the
Jan 08, 2013 Cathy rated it really liked it
I'm only 50 pages in, and I pretty much want to underline every other paragraph and blog about every bit of it. So well thought-out and explained. So far, I think this should be a textbook for students and mandatory reading for every politician.
... EXCELLENT. I dog-eared so many pages and read it aloud to my husband and talked about it animatedly several times. The whole book is clear, well researched, carefully considered and easy to understand. Even for a politician. Goldhill lays out a great
Jun 17, 2014 Robert rated it really liked it  ·  review of another edition

David Goldhill does a very good job of laying out many of the biggest issues in US health care pricing, a field I actually happen to know a lot about. From his experience running a company and being on the board of the Leapfrog Group, Goldhill is in a good position to understand the excessive, and growing, costs of our current system to individuals and companies, as well as the challenges in achieving price and quality transparency in health care.

Although he superficially comes out against the A
John Doyle
Jan 14, 2015 John Doyle rated it really liked it
Shelves: healthcare
Goldhill's father died as a result of medical error in a hospital that then billed insurance and Goldhill's mother $635K for the "care." The author directed his pain and anger to an outsider's examination of America's health care system. The result is a clear, richly exemplified description of the structural features of American health care that inevitably lead to excessive cost, poor quality, and systemic disregard for the best interests of the "customer." Among the possible solutions Goldhill ...more
Jan 25, 2013 Nate rated it liked it
Overall, I found the book to be fair and thought-provoking, but the idea of a "Wal-mart of healthcare" sounds pretty repulsive to me. If anything, the book does a good job of explaining the complexities of health care and Goldhill does have a humane approach to the subject. I guess I just don't have as much faith as the author in a health system left to the devices of the free market.
David Meyers
Oct 05, 2013 David Meyers rated it it was ok
While the author makes some good points about issues in the healthcare system and the flaws within the ACA, he approaches the issue from the standpoint of privilege and his suggestions don't really hold up for the majority of Americans.
Mar 15, 2013 Andria rated it it was ok
I wanted the book to be more of a personal story and instead it was a much more political-science based representation of American healthcare. There were some extremely interesting facts - it just wasn't what I was expecting or wanting from the read.
Jun 08, 2013 Seth rated it really liked it
Shelves: 2013
Very compelling. I don't agree with everything he's proposing, but I appreciate that he brought facts, and didn't yell at me.
Dec 15, 2014 Joe rated it it was amazing
The fact is that our health care payment system is completely messed up. The incentives are all out-of-whack and, as a result, we're dramatically overpaying for the level of care we receive and there is a very distinct disconnect between the consumers of healthcare and how much they think they're paying for it.

Goldhill does a very good job laying out the economic incentives inherit in our current system and also outlining your actual cost for the health care you receive - which is drastically hi
Rochel Dick plonka
Oct 19, 2016 Rochel Dick plonka rated it really liked it
Great book that explains what is so wrong with American health care. The author beats a dead horse a bit by repeating the same idea again and again. I wish he would have spent more time talking about the solutions and less time repeating the same idea over and over. His Atlantic article is the Cliff notes version, if you don't want to read the whole book.
Neil Pierson
Dec 04, 2015 Neil Pierson rated it it was amazing
If you're serious about understanding what's wrong with the U.S. health care system, this is the book for you. I stress serious, because let's face it: Non-fiction about a complex system that is crashing around us isn't exactly a beach read.

Kudos to the author, though, for making the subject very readable. You don't need any grounding in jargon or the health care system. And you get used to his style, which is to grab you by the lapels and speak LOUDLY.*

The root of the problem, the author believ
Malin Friess
May 23, 2013 Malin Friess rated it it was amazing
Why is healthcare so costly?

1) Language matters. Why do we talk about Health Care COSTS instead of Health Care PRICES? It's wishful thinking. Is it too uncomfortable to think about putting a PRICE on grandma's care at the ED? Every bill, appointment, test, crown, filling (I'm a dentist) reflect someon's time, labor, skill. Let's call it what it is..Health Care has prices.
2) Health Care isn't Health! The bottom line is that nutrition, exercise, education,refraining from tobacco use, having a fait
Charles Berteau
Sep 18, 2014 Charles Berteau rated it it was amazing
This is, quite simply, an outstanding book. Health care is an incredibly complex topic, but Goldhill's approach is to keep a laser focus on incentives. His main theme is how we misguidedly treat healthcare as a unique industry, and disassociate the consumer (and his/her spending choices) from the providers, who then have no incentive to improve.

The author is a Democrat, but began to examine his predilections after watching the death of his father (who walked into a highly regarded hospital with
Daniel Barros
Apr 28, 2016 Daniel Barros rated it it was amazing
This book should be required reading for anyone who's ever wondered, "well, what exactly is so bad about our healthcare system?" In this fascinating read, David Goldhill approaches the matter of care from the lens of a business person, which I can wholly appreciate. The problems we face in healthcare today, he contends, are primarily a result of a broken marketplace for healthcare. We are not consumers in this system, we are pawns for powerful surrogates to extract profit from.

Goldhill takes us
Jul 22, 2014 Matthew rated it it was amazing
Phenomenal analysis of the problems of the American health care market and its out-of-control "costs." Goldhill, a self-described liberal Democrat (but also a highly successful businessman) makes a very convincing case for the need for free-market reforms. The root of the argument is simple -- if nobody making the buying decisions knows what the prices are or the real costs or values that lie behind them, no real market can function. The domination of the market by "insurance" that we expect to ...more
Jan 09, 2014 Ginny rated it it was amazing  ·  review of another edition
This is a great book for those of us not in the medical or economic fields. We think we know the problems with health care? No way. Everybody should read this. The system is crazy. We spend over $8K per capita per year on health care, yet our quality of life indicators rank among the lowest of all developed nations. That's DEVELOPED nations. Why? Because the entire system is flawed and instead of throwing it out and starting over, we keep trying to fix flaws with ever-more flawed policies. It's ...more
William Nist
Aug 01, 2013 William Nist rated it really liked it
Most of us have had horrible run-ins with our health care system. The author certainly has! But instead of grinning and bearing it, he actually has a prescription. It won't make any side of the current debate happy, and it may in fact be out of our societal political reach. In a nutshell, He was to relegate insurance and insurance companies to a universal, very high deductible status. He want all routine and chronic medicine to be left to the pressures of the market, so that competition can lowe ...more
Suzette Iverson
Phenomenal and ground breaking. Also depressing; he is perfectly right, that the ACA is likely to drive up costs; costs have already been driven up by the lack of controls on Medicare and Medicaid and by the shift of payments from consumers to insurers. His solution for all this is a market-based solution. But he clearly doesn't know medicine. While he is correct about the problems, he envisions a solution where every patient/consumer would weigh the amount in their health savings accounts again ...more
Oct 31, 2013 Devorah rated it really liked it
The subtitle of this book is "How American Health Care Killed My Father and How We Can Fix It." Mr. Goldhill thoughtfully and persuasively delivers on both parts of that subtitle. The clear thinking and meticulous research and analysis he brings to this very complex and troubling issue was a breath of fresh air. Each chapter is laid out logically, buttressed by necessary but not overwhelming data, and calmly discussed without the emotional excess one might expect from the subtitle. Mr. Goldhill ...more
Nov 13, 2013 Tim rated it it was amazing
This book should be required reading if one is to vote in the USA. The issue is that imperative.

Goldhill effectively hits a home run on every page, and explains in great detail why the current health system in the US is both flawed and doomed.

Are you a liberal that thinks the tea baggers are nuts for wanting to repeal ACA? This book is for you.

Are you a tea-party type that would love to see ACA repealed? This book is for you.

Are you at all concerned about our health care system or the people wan
Mar 05, 2013 Kafkasfriend rated it liked it
Very good essay, questioning the relationship between money and health, health as a care, not a financial option, defined by dollars for a life

There are some odd comments in the book, such as the claim that there is no indication that paying for healthcare has resulted in death, when we know that there are many cases of people turning down healthcare because of the cost (the recent case of a cure for HIV being derived from a woman who terminated her treatment because of the cost being a case in
Mar 16, 2013 Cody rated it really liked it
This is a well written book. It attempts to tackle the reality of our healthcare system in a way that sheds light on the misinformation fed to consumers and misconceptions people have. It blows Obamacare out of the water with analysis instead of liberal rhetoric. The bottom line here is that the country is screwed if we don't make drastic changes to spending and the moral hazards doctors create by tacking on additional procedures just because health insurance will cover it. The author postulates ...more
Health care costs too much, kills and injures too many, is unavailable to too many.

The author's solution: The government annually gives everyone the amount the average person spends on healthcare per year. That goes into a health savings account. Everyone pays their healthcare providers from their account. If someone needs more care that they can pay for, they can borrow against their future HSA deposits. Everyone would buy catastrophic insurance from their HSA that would pay for care that cost
Jan 13, 2013 Deborah rated it really liked it  ·  review of another edition
Veered between a 3 star and 4 star rating for this one. The writing was great and the issues covered in a straightforward and unemotional manner, despite the emotional connection to the author's father's death. My main issue with the book was that it repeated itself a lot. There wasn't enough 'different' information, or at least the information could have been presented in somewhat different ways. I really think the content could also have been edited down. That said, I, like many others think i ...more
Mark Casey
Apr 12, 2016 Mark Casey rated it liked it
This is a solid read about the how the US health care system actually works in practice rather than how people think it works, or how it is supposed to work in theory. I have seen more detailed explanations, particular of how Medicaid works, but the overall story is effectively told here.

The best rhetorical device used by the author is to contrast how health care ("The Island") works compared to how nearly every other industry ("The Mainland") works.

The solutions proposed by the author sound pr
Jan 13, 2013 Trevor rated it really liked it
Advocates that we should be paying for health care using something the Singapore model which seems would be a lot better than the insane system we have right now. Routine health care payments would need to be paid from the users mandated (and employee/employer/government contributed) health account and large unexpected payments could be covered by taking a loan against future health account contributions (possibly including debt forgiveness) as well as payments from true catastrophic health insu ...more
Linda Ethier
Feb 26, 2013 Linda Ethier rated it it was amazing
A sobering analysis of American health care finance - the causes of its disfunction and real solutions for its remedy. The author is convincing in his argument that there are, indeed, ways to halt the crisis we are experiencing, but actually taking action with those solutions would be extremely difficult thanks to the special interest groups that have every reason to maintain the status quo. Contains a critical analysis of the Affordable Care Act, which he argues has good intentions, but only bu ...more
Jan 13, 2013 Steve rated it really liked it
Liked the book pretty well. Author has some good ways of explaining healthcare system problems and I think his suggested solutions make sense. I wish he had not used some metaphors so frequently - he refers to US healthcare as an "island" meaning that it operates very differently than other parts of life in the US. OK that's a fine metaphor, but then he relentlessly uses the term "island" throughout the book to refer to US healthcare, which irritated me. But I liked the book anyway, and would re ...more
Aug 19, 2013 Pamela rated it really liked it
Good 4.4 Covers many problem areas in the delivery and financing of American health-care. Mr. Goldhill proposes some interesting plans for improvement, including coverage for medical catastrophes but increased patient-consumer responsibility for payment for more routine care and medications; the plan involves Health Care Accounts. He considers that this approach would put higher demands on the medical providers and hospitals to improve care and reduce costs. The approach would also encourage pat ...more
Trey Palmer
Aug 06, 2013 Trey Palmer rated it really liked it
An expansion of an article the author wrote for the Atlantic Magazine several years ago which was "highly praised and completely ignored," this book presents an excellent analysis of our dysfunctional health care system and provides many sensible suggestions for its improvement. Written for the general reader from the viewpoint of a successful businessman, Goldhill makes the argument that a market based system that includes a catastrophic event safety net would be a vast improvement over the pre ...more
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“A recent Economist article on dialysis perfectly illustrates the inflationary impact of cost-plus pricing. Since U.S. clinics are paid on a cost-plus basis, they prefer to use expensive drugs rather than cheaper ones. In fact, many appear to order drugs in units that exceed what a standard dosage requires because they can charge the government for the wastage. Quoting a stock research firm, the article noted that many clinics preferred an injected drug with a price of $4,100 a year over the identical drug in oral form, priced at only $450 a year. Not surprisingly, the manufacturer of the oral drug responded by increasing its price above that of the injected version to make it more competitive!” 0 likes
“But though I admire their intentions and ambitions, I contend that they have missed the big picture: the underlying insurance-based structure of our health care system drives excess treatment, cost inflation, and medical errors. It is this structure that needs to be changed.” 0 likes
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