An American Sickness Quotes

“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.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“To get products approved, firms had to create applications to prove that medicines were ‘”safe and effective”, meaning more effective than doing nothing at all. That standard was never refined to include the more modern question: Is the product more effective than the dozens of other treatments for a particular conditions that are already on the market? Equally important, the FDA yardstick for approval did not include any consideration of price of cost-effectiveness – a metric that virtually all other countries now use as they consider admitting new drugs to their formula.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“The price of a Prius at a dealership in Princeton, New Jersey, is not five times higher than what you would pay for a Prius in Hackensack and a Prius in New Jersey is not twice as expensive as one in New Mexico. The price of that car at the very same dealer doesn’t depend on your employer, or if you’re self-employed or unemployed. Why does it matter for healthcare?”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Collectively, the medical industry has become the country’s biggest lobbying force, spending nearly half a billion dollars each year. In 2015 the oil and gas industry spent $130 million, securities and investment firms about $100 million, and the defense/aerospace industry a mere $75 million.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Studies have showed that hospitals charge patients who are uninsured or self-pay 2.5 times more than they charge covered by health insurance (who are billed negotiated rates) and three times more than the amount allowed by Medicare.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“To get products approved, firms had to create applications to prove that medicines were "safe and effective”, meaning more effective than doing nothing at all. That standard was never refined to include the more modern question: Is the product more effective than the dozens of other treatments for a particular conditions that are already on the market? Equally important, the FDA yardstick for approval did not include any consideration of price of cost-effectiveness – a metric that virtually all other countries now use as they consider admitting new drugs to their formula.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Total cash compensation for hospital CEOs grew an average of 24.2 percent from 2011 to 2012 alone, which increasingly includes bonuses as well. Those bonuses are linked to criteria such as “finance,” “quality”, “profit”, “admissions growth,” and “increase in net funds”, not medical goalposts like reducing blood infections or bedsores and avoiding unneeded procedures.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“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]”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“The earliest health insurance policies were designed primarily to compensate for income lost while workers were ill.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Templates for Protest Letters 1. TO TACKLE A SURPRISE OUT-OF-NETWORK BILL Dear Sir or Madam: The bills enclosed were for out-of-network services performed on __________ during my admission to __________ Medical Center, a hospital that is in my insurance network. I went to __________ Medical Center precisely because it was in my network. I was not informed of these providers’ out-of-network status and did not consent to being treated by any out-of-network providers. Since I did not give informed consent for treatment beyond the terms and network of my insurance policy, I suggest you contact my insurer to work out payment; I will pay only that portion of the bill that I would have paid for in-network services. Please stop this effort to collect a bill I do not owe for a service I was never informed would be out-of-network. If I get another notice, I will report this collection effort to the __________ State Department of Insurance and __________ State Department of Consumer Affairs. Sincerely, 2. TO OBTAIN MEDICAL RECORDS AND ITEMIZED BILLS Dear Sirs or Madam: I have now requested my medical records/itemized bill __________ times and have yet to receive the material. It is my right to receive these”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Many patients can’t shake the idea that the one-on-one relationships with doctors that once earned the profession our respect and allegiance may no longer be medicine’s driving force. When”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“But even if Congress didn’t appreciate the value of the medical profession, there were many other revenue streams that doctors, particularly specialists, could turn to, and, in short order, many did.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“For hospitals and insurers, observation status has benefits. For patients it is a disaster.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“More than two-thirds of the country’s hospitals are not-for-profit, and IRS rules state that nonprofit CEOs should receive only “reasonable compensation,” which it advises should be determined in part by considering salaries at similar organizations. But, as also occurs in the corporate world, the CEO typically picks the compensation consultant and controls who is on the board.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“As healthcare became a business, hospitals could have spent their operating surpluses on raising pay for nurses and orderlies, or reducing list prices for patients. But there was not much commercial incentive to do that.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“In fact, there is much to suggest that hospitals have turned residencies into another profitable business.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“As obesity rates climbed, medical equipment companies devised new operations using new products to help combat the condition, and bariatric surgery was a boom field. Companies, hospitals, and doctors’ groups lobbied successfully to have insurers pay for it all. Being overweight was rebranded as a disease.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“A Center for Public Integrity (CPI) investigative series in 2012 found a huge increase between 2001 and 2008 in Medicare billing for levels 4 and 5 visits among emergency room patients who were sent home, from a quarter to nearly half of all patients. Meanwhile, the proportion of level 2 visits decreased by about half, to just 15 percent.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“The phenomenon known as “upcoding” didn’t come into existence overnight.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Today just about every hospital employs strategic billing, which is enabled and supported by consultants and healthcare advisory firms, large and small. Deloitte is ranked number one”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“For the business departments of hospitals and doctors on staff, the discovery was transformational. The billed price of an item could be completely decoupled from its actual cost.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“All hospitals have a master price list—a chargemaster—and adjusting it to maximize income was the focus of Deloitte’s strategy. To squeeze more money from the purse, Deloitte advised hospitals to stop billing for items like gauze rolls, which insurers rarely or never reimbursed, and to boost charges for services like OR time, oxygen therapy, and prescription drugs.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“HMOs succeeded at containing costs at least for a while. The 1990s were the only decade since the 1940s when U.S. health spending did not increase faster than the cost of living. But most hospitals dragged their heels in creating quality cost-effective care to attract managed care contracts, and these lackluster offerings tarnished the HMO concept in some parts of the country, perhaps forever.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Once acceptance of health insurance was widespread, a domino effect ensued: hospitals adapted to its financial incentives, which changed how doctors practiced medicine, which revolutionized the types of drugs and devices that manufacturers made and marketed. The money chase was on: no one was protecting the patients.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“By the 1990s, the Blues, which offered insurance in all fifty states, were hemorrhaging money, having been left to cover the sickest patients. In 1994, after state directors rebelled, the Blues’ board relented and allowed member plans to become for-profit insurers. Their primary motivation was not to charge patients more, but to gain access to the stock market to raise some quick cash to erase deficits.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“these for-profit plans slowly gained market share through the 1970s and 1980s. It was difficult for the Blues to compete”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“Suddenly, at a time when medicine had more of value to offer, tens of millions of people were interested in gaining access and expected their employers to provide insurance so they could do so. For-profit insurance companies moved in, unencumbered by the Blues’ charitable mission. They accepted only younger, healthier patients on whom they could make a profit. They charged different rates, depending on factors like age, as they had long done with life insurance. And they produced different types of policies, for different amounts of money, which provided different levels of protection.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“The former covered hospital care and the latter doctors’ visits. Between 1940 and 1955, the number of Americans with health insurance skyrocketed from 10 percent to over 60 percent. That was before the advent of government programs like Medicare and Medicaid.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“The original purpose of health insurance was to mitigate financial disasters brought about by a serious illness, such as losing your home or your job, but it was never intended to make healthcare cheap or serve as a tool for cost control. Our expectations about what insurance should do have grown.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

“When the National War Labor Board froze salaries during and after World War II, companies facing severe labor shortages discovered that they could attract workers by offering health insurance instead. To encourage the trend, the federal government ruled that money paid for employees’ health benefits would not be taxed.”
― Elisabeth Rosenthal, An American Sickness: How Healthcare Became Big Business and How You Can Take It Back