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

by Elisabeth Rosenthal

THIS U.S. HEALTHCARE SYSTEM gradually evolved sector by sector, hospital by hospital, doctor by doctor. What the players are doing is, technically speaking, perfectly legal. Participants in the marketplace respond to the incentives and opportunities a market allows. That’s what they’re supposed to do. Each component of the system is genuinely convinced that it’s not so bad, not responsible for our $3 trillion medical bill. Someone else is more to blame. Drug spending is only 10 percent of the national health budget! Nursing homes are only responsible for 5 percent of health costs! Payments to doctors only 20 percent! Dermatology accounts for only 4 percent of Medicare expenditures! Each segment of our medical system is convinced that its charges are reasonable. But put all the little excesses together and you get healthcare that is much worse and much costlier than the sum of its parts. We, the patients, are stuck in the middle, and it seems we’ve reached critical condition.