The Price We Pay Quotes

“How did medicine transform from a charitable profession to one that has put one in five Americans into collections for medical debt? How did we get to the point where hospitals are scientifically advanced bastions of academic genius, but can’t even tell you what an operation will cost? How did the noble profession of healing allow billing practices to become so predatory that some hospitals sue and garnish the wages of half of the people in the town they serve? How did we get to this point where American businesses have lost their competitiveness overseas because of health care costs? How did we get to a point where Starbucks spends more on health care than coffee beans and General Motors spends more on health care than steel? Or where some types of overtreatment have reached epidemic proportions, and medical error is a leading cause of death in the United States? How did we arrive at this moment where pharmacists are contractually forbidden to tell a patient what’s in their best interest, and middlemen work in a fog of transactions so opaque that a special law was passed to grant them exemption from antikickback laws? These money games become so accepted that ordinary people like Karen are getting charged $21,000 for an ineffective minor procedure, and meanwhile, she has no idea that she’s a victim of the game.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“The national Choosing Wisely4 project, our Hopkins-based Improving Wisely5 project, and the High Value Practice Academic Alliance6 represent a few simple ways to get involved.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“Dr. Benjamin Rush, son of a blacksmith, remembered his Philadelphia roots growing up in a family without much money. His dedication allowed him to become a physician and care for the poor regardless of their ability to pay. Serving as a voice for those with psychiatric disorders, he devoted his medical career to destigmatizing mental illness. He fought on behalf of those who couldn’t fight for themselves, including people suffering from schizophrenia who were chained down in institutions because society did not understand their illness. Because having mental illness often meant living in extreme poverty, Rush would often serve his patients without being paid. But that didn’t stop him. Considered the forefather of psychiatry, he held strong views on equality, even publicly calling for the abolition of slavery, declaring it a crime. Dr. Rush would later become one of five physician signers of the Declaration of Independence. He was at George Washington’s side during the crossing of the Delaware, and he treated injured soldiers behind enemy lines. His duty to serve the sick and injured of society rose above any other allegiance. Dr. Rush was among the first to call for equal rights for women, free education and health care for the poor, citywide sanitation facilities, an end to child labor, universal public education, prison reform, and an end to capital punishment. He was highly critical of tobacco smoking and was known to call out physicians when he observed greed and incompetence among them.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“The day the polio vaccine was announced as safe and 90% effective, Jonas Salk refused to commercialize it or obtain a patent”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“To lower costs, we must take on the powerful stakeholders. It’s easy to blame bacteria for our health care woes, but infections are not the reason your premiums went up 15% last year.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“Interestingly, when it came time to vote for an opioid prescribing limit, patients always voted for fewer pills than the surgeons.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“Many other industries have their practice patterns measured. In 2009, the utility company Positive Energy (now Opower) was interested in reducing power use in neighborhoods. Their data showed that some households used far more electricity than their neighbors. After all, there are no standardized protocols on turning lights on or off when one vacates a room. Just ask anyone who’s argued with a spouse about this issue. The company decided to mail each household a regular feedback report that compared their electricity and natural gas usage to that of similarly sized households in their neighborhood. Playing on the benchmarking theme, the data feedback intervention resulted in an overall reduction in household energy use. When people saw they were outliers, they modified their habits so their usage fell more into line with that of their peers. In a year, this simple intervention reduced the total carbon emissions of the participating houses by the equivalent of 14.3 million gallons of gasoline, saving consumers more than $20 million.4 Lots of utility companies now take this approach—and it works.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“...I was often reminded of the deep trust people have in their doctor. Patients are willing to let me put a knife to their skin within minutes of meeting me, or to divulge secrets they've kept for a lifetime–just because I'm a doctor.”
― Marty Makary, The Price We Pay: What Broke American Health Care—and How to Fix It

“When I go to policy conferences and hear experts say “The only important thing in health care is outcomes,” I feel torn. I want to agree with them, but I know the subtleties involved in how the starting population is defined. If you have unnecessary surgery with no complications, that's not a great outcome.”
― Marty Makary, The Price We Pay: What Broke American Health Care—and How to Fix It

“So how is it that health insurance costs have been skyrocketing? It’s explained by the money games of medicine, loaded with middlemen, kickbacks, and hidden costs.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“Consider this simple fact: Last year, physicians prescribed a record 4.5 billion medications.2 That’s about double the number we prescribed just a decade ago. Did the incidence of disease double in the last ten years? Of course not. Most of the doubling represents pills that could be avoided with lifestyle changes or more judicious prescribing. More than half of Americans are now on four or more medications, according to Consumer Reports.3 As if that’s not shocking enough, my research team published a study showing the average person on Medicare is on twelve medications.4”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“It’s ironic that the federal government already has a mandatory disclosure rule for the real out-of-pocket costs people incur at a vulnerable time in their lives. But it’s not a rule for health care—it’s for funeral homes. The Funeral Rule,18 enacted by the Federal Trade Commission in 1984, requires funeral providers to offer itemized pricing information to consumers before they purchase any services.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It

“Our team eventually identified about 1,100 U.S. churches, synagogues, and mosques that served as vascular screening centers13—despite a scientific consensus that people should not be screened this way for this disease.”
― Marty Makary, The Price We Pay: What Broke American Health Care--and How to Fix It