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An American Sickness

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

By Elisabeth Rosenthal
18-minute read
Audio available
An American Sickness: How Health Became Big Business and How You Can Take It Back by Elisabeth Rosenthal

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.

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

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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An American Sickness

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

By Elisabeth Rosenthal
  • Read in 18 minutes
  • Audio & text available
  • Contains 11 key ideas
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An American Sickness: How Health Became Big Business and How You Can Take It Back by Elisabeth Rosenthal
Synopsis

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.

Key idea 1 of 11

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.

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