An American Sickness Buchzusammenfassung - das Wichtigste aus An American Sickness

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Zusammenfassung von An American Sickness

Name: An American Sickness
Rating: 4.3 (42 reviews)
Author: Elisabeth Rosenthal

Elisabeth Rosenthal

How Health Became Big Business and How You Can Take It Back

4.3 (42 Bewertungen)

25 Min.

Themen

US Economics Medicine & Natural Remedies US Politics

Inhaltsübersicht

An American Sickness
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What’s in it for me? Get a better understanding of the US health-care system.

Over the last few decades, health care has become a major point of debate in the United States. Politicians of all stripes argue over the price of medicine and different approaches to health insurance, but, though everyone seems to agree that something isn’t working, no one seems to have a clear idea of exactly how to fix it.

How did it come to this? In these blinks, we‘ll dive deep into the US health-care system and explore why the United States approaches treatment of the ill very differently than most other Western nations. We’ll look at the history of health care, as well as the current situation and possibilities for the future. There may be a way to save a system that most parties agree is sick.

You’ll also find out

why prescription drugs are so expensive in the United States;
that hospitals make money on tests you might not need; and
what you can do to start reducing health-care costs now.

The American health-care system went from humble beginnings to high profits.

In the grand scheme of things, the American health-care industry isn’t very old. It emerged around 1900, with the introduction of the very first health-insurance policies, which were designed to compensate workers for income lost during illness.

The earliest US insurance companies were nonprofits that aimed to help hospitals get paid while also helping patients save money.

For a long time, Blue Cross and Blue Shield were the only major health-insurance companies. But in the 1950s, a decade during which the number of Americans buying health insurance jumped by 60 percent, it became clear that insurance was big business. Soon, for-profit companies started taking over.

Since then, health insurance has remained an extremely profitable business.

To understand just how big the industry has become, let’s look at Jeffrey Kivi, a New York chemistry teacher who has been treated for psoriatic arthritis since childhood. People with this condition have an over-responsive immune system that attacks their skin, and, without regular infusions of a drug called Remicade, their life would be almost unbearable.

Jeffrey’s treatments used to cost $19,000 every six weeks, and his insurance always covered it. But then, when Kivi’s doctor moved to another hospital, a single infusion suddenly started costing $130,000. Jeffrey was surprised when his insurance company picked up the tab, no questions asked.

It might seem crazy, but nowadays, insurance companies are actually looking for such absurdly high bills.

In 1993, Blue Cross spent 95 cents of every dollar they earned covering medical costs, but in the following years they decided to keep most of that money as profit. That is, until the Affordable Care Act (better known as Obamacare) required insurers to spend at least 80 to 85 percent of every dollar earned on patient care.

This requirement is what made Jeffrey’s insurance company so happy to pick up that $130,000 tab. Since they make so much money, they need to spend a lot of it in order to adhere to the rules.

But this is only scratching the surface of what’s going on in today’s American health-care system.

Hospitals are being run like any other profit-seeking corporation.

The origins of many American hospitals, most of which began as charitable institutions set up by religious groups, can be traced back to the nineteenth century.

But today, hospitals are more like major corporations than philanthropic foundations.

Doctors are a lot like entrepreneurs looking for new revenue streams.

In 1990, the American College of Surgeons required its members to make a pledge that included these words: “I will set my fees commensurate with the services rendered.” Unsurprisingly, this statement was removed from the pledge in 2004.

While it’s fair to expect doctors to be reasonably compensated, given their years of intensive education and training, the definition of “reasonable” has recently been stretched to a patently unreasonable degree. Today, America’s wealthiest one percent includes around 27 percent of the nation’s doctors.

Pharmaceutical corporations manipulate patent laws and prices to keep profits flowing.

Like hospitals, many of the big US pharmaceutical companies can be traced back to the nineteenth century. Back then, they were small businesses selling tonics and potions that succeeded in mixing a little bit of science with a whole lot of fanciful marketing.

Though this formula for success sounds quaint, the sad truth is that it hasn’t changed all that much. Prices, however, have.

Medical-device companies are in the dangerous position of having little competition and oversight.

In 2006, Robin Miller’s brother had a heart attack and during his recovery he required an implantable defibrillator, which is similar to a pacemaker. Robin’s brother was uninsured, so Robin agreed to cover the costs. But neither the hospital nor the manufacturer would tell him exactly what these costs would amount to.

This particular case is representative of a general problem. Much of what goes on in the area of medical devices is hidden from customers, and yet these devices are often the single most expensive part of a medical bill.

Hospitals have become greedy conglomerates, eager to earn profits through unnecessary tests and services.

If you’ve ever worked in the service industry, you may know that restaurants make most of their profit by selling expensive cocktails and drinks.

As it turns out, hospitals have their own version of this. But instead of booze, they make the real money from testing and ancillary services, such as physical therapy sessions.

Health-care organizations are more interested in money than patient care, something the Affordable Care Act tried to fix.

In a 2014 study of US customer debt, 52 percent of the overdue debt on current credit reports was the result of unpaid medical bills. In fact, one out of every five Americans had medical debt that was affecting their credit score, and therefore their chances of buying a car or getting a loan or a mortgage.

While we’ve looked at many of the reasons for massive medical bills, it all boils down to this: health care today is being run like big business.

There are steps Americans can take to reduce the costs of medical care.

You’ve probably heard about the refugee crisis, but have you heard of “health-care refugees”? This is the growing number of middle- to upper-middle-class Americans who are moving to other countries in an effort to avoid unbearable medical costs.

The author once met a graduate student with diabetes who was searching for an academic position abroad because she could no longer afford treatment in the United States.

Choose your hospital and insurer wisely, and don’t be afraid to speak up.

Before trying a new restaurant these days, people tend to check online reviews. This is something you can – and should – do before picking a hospital as well.

Many hospitals in the United States are reviewed on Yelp, and the customer reviews to be found there can give you a good idea of what to expect. U.S. News & World Report publishes a ranking of the country’s best hospitals that takes into account their reputation within the medical community. This valuable resource also considers the ratio between nurses and patients and the number of medical mishaps. And then you can always check Medicare’s online Hospital Compare program, too.

There are ways to reduce the costs of medications and medical services.

In a 2015 poll, 72 percent of Americans said they felt the cost of prescription drugs was unreasonably high and approximately 25 percent reported difficulties in paying for their medication. Unfortunately, this problem is even worse for people with poor health.

If you hope to lower your drug expenses, here are a few tips.

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Worum geht es in An American Sickness?

An American Sickness (2017) takes an honest look at the state of the American health-care system and frankly diagnoses its many ailments. When big business started taking over what were once charitable organizations, things began to go truly wrong. Rosenthal presents valuable information on how to reduce health-care bills and not get taken for a ride by greedy hospitals and over-prescribing doctors.

Bestes Zitat aus An American Sickness

The list of hospital CEOs with million-dollar annual salaries is long – even if their hospital is listed as a not-for-profit.

—Elisabeth Rosenthal

Wer An American Sickness lesen sollte

Americans, both healthy and sick
Workers in the health-care and insurance industry
Readers who want to save money

Über den Autor

Dr. Elisabeth Rosenthal, after spending many years as a correspondent and reporter for the New York Times, became editor-in-chief of Kaiser Health News, a position she still holds. A graduate of Harvard Medical School, she has invaluable experience as an ER physician and extensive training in internal medicine.

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