An American Sickness by Elisabeth Rosenthal

33521680._sy475_Nonfiction – Kindle edition. Penguin Press, 2017. 412 pgs. Purchased.

Subtitled “How Healthcare Became Big Business and How You Can Take It Back”, Rosenthal’s book is neatly split into two parts: one answering how healthcare came a profit-maximizing business and another attempting to offer readers ways to control their own bills.

The first section examines all the reasons Americans have been told their healthcare costs so much – cost of innovation, greedy pharmaceutical companies, doctors drowning in debt – and then explores additional reasons that are often kept from the public or obscured behind employer-provided health insurance plans.

It’s a labyrinth of information to wade through, but Rosenthal does an excellent job of explaining the important details and breaking down this complex system into understandable portions. The information she provides is eye-opening and informative, and I appreciated how she addresses every part of the American healthcare industry.

Too often, books on this topic pick a single entity to place blame on. Rosenthal’s book shows that the system is rotten from the core – the whole is intangible from the part —  and it starts to feel like she is setting up for the book to end with the conclusion that only a single payer, government-run system will fix our unnecessarily expensive system.

“The alarming statistics are incontrovertible and well known: the United States spends nearly one-fifth of its gross domestic product on healthcare, more than $3 trillion a year, about equivalent to the entire economy of France. For that, the U.S. health system generally delivers worse health outcomes than any other developed country, all of which spend on average about half what we do per person.”

Except that’s not the only conclusion Rosenthal reaches. She tries her best to offer solutions that individuals can apply without waiting for a complete overall of the system. For example, my father’s orthopedic surgeon recently added a surgical wing to his stand-alone office, which Rosenthal’s books explains may be a way of allowing him to charge additional high fees under the guise of being a hospital.

Should my dad require another surgery (god forbid), Rosenthal suggests we question his doctor about these fees and inquire if the fees will make the surgery cost as much as conducting it in the hospital. Of course, his doctor could waffle on providing a straight answer and, as Rosenthal explains, it may not matter for my dad’s final bill given that he has insurance. But it could keep costs down overall, ergo helping with premiums all Obamacare recipients pay.

That said, haggling and questioning is easier when a surgery is elective or planned. My mom ended up in the hospital several times with infections while battling cancer, and it never once crossed my mind to question who was in the room or what the hospital planned to charge. I just wanted them to help her immediately.

Rosenthal recognizes this situation and tries to adjust her advice for accordingly, although these adjustments only help to stress how her solutions are merely Band-Aids. We need Medicare for all. But, for those Americans who hear ‘Medicare for all’ and start imaging bureaucrats deciding who lives and who dies, her myriad of solutions might make for an informative yet still politically conforming read.

This is my fourteenth book for #20BooksofSummer. When I made my list for the challenge, I didn’t anticipate how much traveling I’d be doing between June and September and didn’t include a single title off my Kindle, which is my go-to while traveling. Thankfully, Cathy is flexible with her “rules” for this challenge, allowing participants to swap in other books and count them towards their challenge total. I purchased the Kindle version of ‘An American Sickness’ in October 2017.

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