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

by Elisabeth Rosenthal

In another case, a Canadian who wintered in Arizona was charged $210,000 for a failed attempt to take out a hip implant that had become infected. (That total doesn’t include the $28,000 he had to pay for an air ambulance to get him back to Canada, where a successful surgery was performed for free.)

“We had software for dictation, and it would even say, ‘You need to check two more boxes for level four.’” A questionnaire filled out by a patient can be labeled as a “health needs assessment,” which is a billable item. Injecting a patient’s bum knee with steroids can be coded as “surgery” costing $1,200.

the FDA yardstick for approval did not include any consideration of price or measure of cost-effectiveness—a metric that virtually all other countries now use as they consider admitting new drugs to their formulary.

was there a mechanism to revoke FDA approval or take drugs off the market if scientific studies by academics proved them to be without benefit. An in-depth data investigation by the Milwaukee Journal Sentinel and MedPageToday in 2014 revealed that, thanks to surrogate endpoints, 74 percent of cancer drugs approved by the FDA during the previous decade ultimately did not extend life by even a single day.

Many of the same drugs in Europe still cost $15,000 a year because countries there bargain with the pharmaceutical companies for a national price, which Medicare is not legally allowed to do.

The program allowed companies to keep selling cleared class 2 products even if the “predicate device” to which their device was “substantially equivalent” had been recalled because it had proved harmful.

Medical coding and coders like ours essentially don’t exist in any other healthcare system.

You can have a look at U.S. News & World Report’s Best Hospitals rankings, which rely on reputation within the medical community, as well as a published set of statistical metrics, such as nurse staffing ratios and the number of mishaps after seven common procedures.

If you are assigned to a private room, make it clear that you did not request it and would be happy to occupy a room with another patient.

When a hospital bill arrives in the mail, request complete itemization. Many hospitals will use umbrella headings like “pharmaceuticals,” “room,” and “surgical supplies” on their bills to try to fudge full disclosure of costs.

Look up the Medicare payment rate for your procedure to determine a reasonable offer.

Informed consent is a bedrock legal and medical principle. This is the essence of your argument: You went to an in-network hospital so that your care would be covered. You were not informed of the out-of-network status of these providers and did not consent to them participating in your care.

U.S. Preventive Services Task Force nor Choosing Wisely, the campaign led by doctors’ groups