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

by Elisabeth Rosenthal

United States spends nearly 20 percent of its gross domestic product on healthcare—more than twice the average of developed countries.

the United States spends nearly one-fifth of its gross domestic product on healthcare,

$3 trillion a year, about equivalent to the entire economy of France.

the U.S. health system generally delivers worse health outcomes than any other developed country, all of which spend on avera...

type of healthcare we get these days is exactly what the market’s financial incentives demand.

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.

Rule 3: Amenities and marketing matter more than good care.)

The very idea of health insurance is in some ways the original sin that catalyzed the evolution of today’s medical-industrial complex.

Medicare uses 98 percent of its funding for healthcare and only 2 percent for administration.

THE COST OF HOSPITAL SERVICES has grown faster than costs in other parts of our healthcare system.

From 1997 to 2012, the cost of hospital services grew 149 percent, while the cost of physician services grew 55 percent.

The average hospital cost per day in the United States was $4,300 in 2013, more than three times the cost in Australia and...

Ten to 15 percent of revenue goes to billing and collection companies and contractors to do things like claims and preapproval—those jobs don’t even exist in Europe.

This is not a healthcare system, it’s an industry, and at every point there’s a way to make money.

Because patients were no longer directly forking out cash or writing checks for their care, hospitals began charging more for their services.

Health insurance is one of the reasons healthcare bills are so high.

Rule 7: Economies of scale don’t translate to lower prices. With their market power, big providers can simply demand more.)

hospital business departments realized if Medicare or a powerful insurer wouldn’t agree to pay a big enough proportion of the rate they wanted, they had the leverage to insist that smaller insurers—and people with no insurance—pay more.

Rule 5: There is no free choice. Patients are stuck. And they’re stuck buying American.)

A Myth: At Least We Get Drugs First

America pays double, sometimes triple, what other developed countries spend on drugs but takes comfort in getting new treatments and cures first.

elected politicians in border states like Maine and Minnesota culling votes by organizing bus tours to Canada to buy prescription drugs illegally.

charge patients who are uninsured or self-pay 2.5 times more than they charge those covered by health insurance

and three times more than the amount allowed by Medicare. That gap has grown considerably since the 1980s.

obesity, which was not considered a disease state until 2013.

I am surprised by this fact.

The discounted contracted rates that your doctor’s finance people have negotiated with insurance carriers are protected by “gag clauses” or other nondisclosure agreements.

Horrific and unjust.

Though some states have declared these illegal and they are of uncertain legal weight in court, doctors may still be afraid to divulge the information.

Doctors are scared to violate the “gag clauses” they make.