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

4.34  ·  Rating details ·  4,932 ratings  ·  859 reviews
A 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
Paperback, 656 pages
Published April 11th 2017 by Random House Large Print Publishing
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Nate This book doesn't take a side regarding the single payer debate. It explains why our healthcare bills are so high; not who should be paying those bill…moreThis book doesn't take a side regarding the single payer debate. It explains why our healthcare bills are so high; not who should be paying those bills. (less)
Tammy Protect your financial interests by questioning whether procedures or devices are necessary. Check if cheaper, older formulations of drugs work just a…moreProtect your financial interests by questioning whether procedures or devices are necessary. Check if cheaper, older formulations of drugs work just as well -- MDs don't know the costs! If you're admitted to a hospital, make sure that you're admitted (versus under observation) -- one is out of pocket, the other is not. If you're admitted, make sure that you specify on the admissions paperwork that you'll only use in-network providers. Make certain your doctor's office isn't considered a "hospital" space -- they will charge you facility fees. On and on...every American should read this book.(less)

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Elyse  Walters
Oct 18, 2017 rated it it was amazing
Audiobook— read by Nancy Linari who was excellent.....
But....there is soooooo MUCH INFORMATION — I almost wish I had bought the hardcopy. I bought the audiobook instead- which has advantages and disadvantages.
The advantage for me: was the easy listening - taking in an overview ( but some parts were so detailed she lost me) - of what Dr. Elizabeth L. Rosenthal had to say —-who was appointed editor in chief of Kaiser health news in 2016, after more than two decades with the New York Times. She r
May 05, 2017 rated it it was amazing
This is an outstanding book that should be read by anyone interested in healthcare and current US healthcare debates.

The book is not about Democrats versus Republicans or about Obamacare and various ongoing efforts to change it. The author is a physician and former NYT writer who knows much about both the practice of medicine and the business of healthcare. The point of the book is that the healthcare sector/industry has come to adopt a business model that is out to fully monetize every aspect
Kristin Butler
May 05, 2017 rated it it was amazing
Doctors, Hospital employees, medical device reps, Health insurance agents anyone in Pharma should read this book. Anyone who touches medical care in any way should read this book. Anyone interested in healthcare reform should read this book.

The nation is fixated on "Healthcare Reform" but most Americans don't seem to understand that the rising cost of healthcare has more to due with the lack of transparency in pricing and the Byzantine American healthcare chaos (system would be too generous a c
Mary Greist
May 22, 2017 rated it really liked it  ·  review of another edition
Well written expose of our healthcare system

As a physician who practiced 35 years and recently retired, I have seen first hand much of what the author describes. It is extremely well researched and well written. It should be required reading for all law makers. Some of the possible solutions discussed seem like bandaids. The only solution I see is a single payer system.
Mar 26, 2018 rated it liked it
I read this book because my colleague and Goodreads friend Divu raved about it -- and I can see why. This book collects up evidence across many domains of healthcare to explain why care is so expensive, sub-optimally delivered, and sometimes low quality in the United States. The book is essentially muckraking of the finest sort.

The first half is devoted to what is wrong, and discusses insurance, hospitals, physicians, drugs, devices, services, billing, fake non-profits, conglomeration, the subor
Apr 11, 2017 rated it it was amazing
really good write up on an overly complex system. This book is really well sourced and approachable. A lot of the content would be funny if it weren't so tragic ...more
Mar 23, 2018 rated it really liked it
This is certainly a very provocative book. I am more than a light user of the U.S healthcare system, and have personally experienced a fair number of ordeals described in the book; even I was shocked by case after case of “runaway” patient bills being cited.
There are three major and mutually dependent factors in any healthcare system: quality, cost and accessibility. The author Elisabeth Rosenthal primarily tackled one of them: cost.
If we compare the dysfunctional U.S healthcare system as a si
If you are lucky every year you’ll stumble across one or two non-fiction books that are so on topic for the current discussion with both tons of useful and informative examples and lots resources and ideas to move forward. This is the book to read this year! It details, in easy to understand ways, how the US healthcare system has spun so far out of control, as well as some common sense solutions to slowly start nudging it back on track.
Gerald Hilton
May 05, 2017 rated it it was amazing
I thought I knew quite a bit about the healthcare system, because of having some chronic health issues. However, I quickly learned that my experiences were either to narrow in scope, or too old to really know our healthcare system. I knew that our system ranked as one of the worlds' worst, for providing quality healthcare to the citizens it's suppose to serve. This book not only shattered any preconceived thoughts of what I thoughts were redeeming values in the system Americans call a "healthcar ...more
David Marshall
May 06, 2017 rated it it was amazing  ·  review of another edition
My 80s-something mother-in-law gave me this book, because she wants her children to have the best tools available to navigate the dysfunctional American health care system. It's a excellent read, diagnosing the illness in the first two thirds of the book, and providing, if not a cure, and least a set of therapies for coping with the sickness in the last third. It dissects the interrelated disease organ by organ, the: 1) insurance companies, 2) hospitals, 3) pharmaceutical industry, 4) doctors, 5 ...more
Aug 03, 2017 rated it it was amazing
An American Sickness: How Healthcare Became Big Business and How You Can Take It Back by Elisabeth Rosenthal

“An American Sickness” is an outstanding expose of what ills the American healthcare system. Dr. Elisabeth Rosenthal takes the reader on an eye-opening journey that covers a wide spectrum of abuses that end up costing the average American. This insightful 412-page book includes eighteen chapters and is broken out by the following two Parts: Part I. History of the Present Illness and Revie
Jun 23, 2017 rated it it was amazing
Shelves: politics-policy
I do most of my reading from the library and rarely buy books or reference them after the fact - I'm seriously considering buying this one.

I work in the healthcare industry and am familiar with some of the practices that impact my corner of the healthcare world. But even though I consider myself to be someone more knowledge than the average American, a lot of what I read just blew me away. As discussion of our healthcare system is at the forefront, we ALL need to understand the financial motiva
Mar 19, 2019 rated it really liked it  ·  review of another edition
Shelves: favorites
An American Sickness is the most eye-opening book I've read so far this year. It takes the reader through how insurance, hospitals, doctors, big pharma, and medical device manufactures, among others, all prey on the system and the patients to wring every possible cent of profit from American healthcare. Though it is the ill and the poor who suffer immediately from this, really every person who pays taxes is subsidizing this greed in the end.

The book is divided into two parts. The first part, whi
Erica Clou
Everyone read this book!! It's about the medical and pharmaceutical industries, and it was written by a doctor. It's not a liberal or conservative book. It's the most educational and relevant book I've read all year. ...more
Ariel ✨
Nov 04, 2019 rated it really liked it
Shelves: health-care
It's hard to know how to rate this book. Every time I opened it up, I got a stomachache. I thought I knew what people meant when they told me, "Insurance companies are evil!" and, "Big pharma is evil!" but it went way beyond my wildest ideas about the human propensity for evil and selfishness.

Dr. Elisabeth Rosenthal first focused on big-picture issues, then narrowed in on individual bills and medications to give us a better idea about how these issues play out in real time. I thought she spent a
Tanmay Jadhav
Feb 07, 2019 rated it really liked it
The long ass title is quite self explanatory.

The book is basically a compilation of stories and history that systematically dissects how the healthcare industry has evolved to be something quite different today than what it was even 50 years ago.

The book dives right to the start of the money epidemic in 1950s and builds itself around the different directions of capitalization it took. Pharma, Biotech, Specialized consultations and orthopedic surgeons earning a 7 figure income by just doing Arte
W. Whalin
May 29, 2017 rated it it was amazing  ·  review of another edition
A Significant Book for Every American

Subtitled, “How Healthcare Became Big Business and How You Can Take It Back” is a new audio book and I heard it cover to cover. Elisabeth Rosenthal has an MD from Harvard but also spent 22 years as a medical reporter for the New York Times. The writing and storytelling in this book is compelling along with thorough research and multiple interviews and sources of information.

The first section of this book tells the story of how medicine and healthcare became a
Janet Newport
A real eye opener. I just wish I had read even half of this 5 years ago.

The appendix was very helpful and worth the price of this book many, many times over.

Thank you Dr. Rosenthal.

PS I very rarely read non-fiction straight through....tend to put the book down to read something more entertaining and then return to can take me a month or two to finish something like this.
This was an exception to my normal reading of non-fiction. I did read it straight through. While the first section o
Jun 26, 2017 rated it it was ok
too long; too technical... A very thorough read about the subject; The author has a negative outlook on the current healthcare system. And, I feel that she does not give both sides to the equation. She reports on most stories saying something to the effect that the healthcare system is a business and patients get the short end of the stick. I wish I could of heard a more balanced view. Maybe, she could highlight on some of the positive aspects of healthcare: such as the access, high quality, and ...more
Steve Nolan
May 06, 2017 rated it really liked it
Pretty comprehensive overview of the American healthcare system. Some crazy anecdotes of people getting screwed and crazy prices for ridiculous things.

Does a great job showing that it really isn't one single thing that's turned the whole system upside down - it's a bunch of individual parts all individually trying to maximize profits. (At the expense of people!)
Barbara (The Bibliophage)
If healthcare in the United States frustrates you, this is the book for you. It alternately made me furious, sad, and empowered me to ask a thousand more questions of my various providers.

I’m sure my own experiences assisted in understanding the context and content of the book. Living with chronic illness necessitates a great deal of medically-related learning. But even if I didn’t have this background, I would have found Rosenthal’s book understandable. She tells patient stories throughout, wh
Mar 02, 2019 rated it it was amazing
Shelves: nonfiction, science
In an era of unprecedented scientific advances—lifesaving drugs, transplant technologies, immunotherapy—medical treatment is more successful than ever in combating disease; however, patients are simultaneously watching the American healthcare system move in the opposite direction, growing ever more expensive, inefficient, and frustrating. Although the United States annually shells out more than $3 trillion on healthcare, our country generally delivers worse health outcomes than developed countri ...more
The Pfaeffle Journal (Diane)
Apr 07, 2017 rated it really liked it  ·  review of another edition
Shelves: 2017
An American Sickness is a frightening book as it lays out how dysfunctional the US medical system has become.

Overall, CMS projected that total health care spending for 2016 reached nearly $3.4 trillion, up 4.8 percent from 2015. According to CMS, U.S. health care spending is projected to reach nearly $5.5 trillion by 2025. The agency attributed the increase in large part to the United States' aging population and rising prices for health care services.
According to the report, national health car
Fred Forbes
Jun 26, 2017 rated it really liked it
We spend 2-3x times what the rest of the world does on healthcare and cover fewer people and with worse results. The probable fix is some sort of single payer system like those used in the rest of the developed world but in the meantime, this book by a Harvard educated MD can help provide you with some defensive measures. Our system has evolved over the last 25 years from a caring, patient oriented system, mainly non-profit to a commercial business enterprise at all levels. Remember the Super Bo ...more
Jun 24, 2017 rated it did not like it
I really, really wanted to like this book. I agree with her on a lot of points, but either through ignorance or guile she's written a book that's easy to understand and fundamentally inaccurate. I'm sure she will sell a lot of copies. I'm also sure that such a simplistic approach to addressing the medical/industrial complex won't make any difference.

Without understanding the economic forces at work and failing to work in the medical field in the US, fixing the pervasive issues are doomed to fai
Scott Rhee
Apr 09, 2018 rated it it was amazing
One would think that, given the fact that we are living in the wealthiest nation on Earth, we would also have the best healthcare system in the world. Sadly, this is not the case. Depending on which study one looks at, the United States consistently comes in around dead-last in every ranking, with the exception of “Country that spends the most on hospital landscaping” or “Most money spent on erectile dysfunction drug commercials”.

Those post-modern shiny new hospital facilities and medical center
Dec 18, 2019 rated it it was amazing
Shelves: audiobooks
wow wow what a way to end my reading challenge. I'm dizzy and angry and I want to die, but I'm definitely too poor to even float the notion. 4.5 ...more
Jun 29, 2020 rated it it was amazing
Shelves: health
Wow! Some of this information I am familiar with, some I suspected and some was new to me. The author provides background information along with some tips/suggestions for healthcare consumers. An enlightening read regarding American healthcare’s current state.
Bonnie Brandt
There was a lot of good information in this book and I do mean a lot. This is a very long book. I work in the healthcare field and even though it made me feel a bit like a prostitute I appreciate the information.

The fact portion of the book, about the first two thirds, was better than the solutions part. I found a lot of the solutions to be a little simplistic and ignorant of the realities of not only healthcare, but the real world and human nature.

For instance, I work in a hospital lab. She s
Stephen Simpson
Jun 19, 2018 rated it it was ok
Very mixed book on a controversial and extremely important subject.

First, the negatives.

If you want to play a game of "Logical Fallacy Bingo", this should be your go-to book. Sorites fallacy, false authority, appeal to authority, false dichotomy, false equivalence, McNamara fallacy, onus probandi, proof by assertion, begging the question, cum hoc ergo propter hoc, furitve fallacy, argumentum ad lapidem, appeal to consequences, ipse dixit, straw man, and so many more... Honestly, this book shou
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41 likes · 18 comments
“ECONOMIC RULES OF THE DYSFUNCTIONAL MEDICAL MARKET More treatment is always better. Default to the most expensive option. A lifetime of treatment is preferable to a cure. Amenities and marketing matter more than good care. As technologies age, prices can rise rather than fall. There is no free choice. Patients are stuck. And they’re stuck buying American. More competitors vying for business doesn’t mean better prices; it can drive prices up, not down. Economies of scale don’t translate to lower prices. With their market power, big providers can simply demand more. There is no such thing as a fixed price for a procedure or test. And the uninsured pay the highest prices of all. There are no standards for billing. There’s money to be made in billing for anything and everything. Prices will rise to whatever the market will bear.” 2 likes
“It's now so dysfunctional that I sometimes think the only solution is to blow the whole thing up.

[Quoting Glenn Melnick, Professor of Health Care Finance at USC]
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