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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

3.84 of 5 stars 3.84  ·  rating details  ·  195 ratings  ·  50 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
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

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
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
John Doyle
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
Charles Berteau
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
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
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.
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.
David Meyers
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.
Jun 15, 2013 Seth rated it 4 of 5 stars
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.
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
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
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
Malin Friess
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
William Nist
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
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
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
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
Catastrophic Care is compelling, and it will ultimately compel me to reread it and examine a good deal of criticism and complementary analysis before I could accept it asproperly digested. The fact that Goldhill inspires this kind of consideration is his book's strongest attribute. If nothing else, I'll never be fully satisfied with the notion that insurance should pay for everything. As a young type-1 diabetic, that's something significant.
Gaurava Agarwal
You should never invest in healthcare until you read this book. It is what any thoughtful insider could tell you about what the real problem with healthcare costs really is. Sanity in an otherwise wholly emotionally covered topic dominated by political rhetoric instead of pragmatic insight that reminds us of the simple, undefeated maxim that incentives matter!!!
I'd despaired of ever understanding why and how the American system of health care turned into such a disaster. But Goldhill does a brilliant job of making that clear. Better still, he has a persuasive vision of the path to regaining safe, innovative, customer-friendly, and comprehensive medical care. We'll never get there until most Americans begin to understand the dynamics that he illuminates, but this book provides a great start to such understanding.
I was very intrigued by the premise of this book and I definitely wanted to like it. However, the author is all over the place and constantly has footnotes to random anecdotes that are extremely distracting from his actual points. I think the author should rewrite this with the help of a more established writer.
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
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
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
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
This contains quite a bit of useful information, and some great metaphors on the topic of insurance -- you wouldn't use your auto insurance for an oil change, right? He does a good job of explaining how the complicated payment system has blurred our understanding of cost. But, there are some limitations here -- he sells too much in his text. His primary experience in health care seems to be talking about it and talking about articles and books he's written on the subject. He comes across as dang ...more
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
J.H. Johnson
Illustrations can be made, but not for everyone.
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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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