On Sunday, December 2nd the book club had the pleasure of spending an hour in conversation with Dr. Elisabeth Rosenthal, the author of An American Sickness: How Healthcare Became Big Business and How You Can Take It Back. You can listen to our full conversation at the end of this post.
Dr. Rosenthal is a graduate of Stanford University and Harvard Medical School. Dr. Rosenthal practiced emergency medicine before joining the New York Times where she was a senior writer. She is currently editor-in-chief of Kaiser Health News, an independent non-profit DC-based newsroom focusing on health and health policy.
In the introduction of the call, you can hear Dr. Rosenthal and P4P founder and host, Cathy Stewart, discuss Dr. Rosenthal’s journey from the emergency room to writing about healthcare reform, thinking she would one day be able to return to her calling as a doctor. Twenty years later, Dr. Rosenthal decided to write An American Sickness and told us that in working on the book she “…dug into each area of healthcare to see for myself really how it came to be that we put profit on the front burner and health on the back burner.”
Give a listen here or below:
Steve Hough of Florida Fair and Open Primaries kicked us off by asking what Dr. Rosenthal’s views were on the demand for the U.S. to move to a single-payer healthcare system. You can hear Dr. Rosenthal’s response and how she feels that the solution to our healthcare crisis is a political decision here or below. On the role of the insurance industry, Dr. Rosenthal thinks “…much of what we get from the insurance world, or from a lot of the layers in our healthcare system, has nothing to do with health care, it adds layers of complexity and cost…”
Our next question came from Cynthia Carpathios of Independent Ohio. Cynthia asked about part two of Dr. Rosenthal’s book—Diagnosis and Treatment: Prescriptions for Taking Back Our Healthcare—specifically how she sees us changing the culture of healthcare and how can we transform our healthcare system into one where patient care is the primary concern. Listen here.
Harriet Hoffman of New York, a consultant who helps people understand the Medicare system and make the best, most cost-effective and access-friendly decisions, raised the push by some for ‘Medicare for All.’ She asked if Dr. Rosenthal thinks a ‘Medicare for All’ system would be viable or even desirable as it is now. Hear her answer or check it out below.
Dr. Jessie Fields pointed out that though the healthcare industry spends $3 trillion a year, our life expectancy is going down in the United States. Dr. Fields went on to talk about how the medical industry is the country’s biggest lobbying force, which requires political reform and the removal of profit incentives from healthcare. Despite all of this, Dr. Fields asked Dr. Rosenthal what glimmers of change she can see. An enlightening discussion followed where Dr. Rosenthal shared her view that “…there’s great hope for a kind of physician-patient alliance to bring change.”
Reverend Carl McCluster, an independent organizer in Connecticut, spoke of how many of his parishioners are suffering from high medical and drug costs. Reverend McCluster asked Dr. Rosenthal for three suggested steps that advocates could take to push back against the medical industry. Listen to how to fight back here.
Susan Massad, a retired physician and a clinician educator of over fifty years, worked with young physicians on their listening skills and their abilities to respond to patients. Susan asked if there are things that Dr. Rosenthal thinks patients should be doing that will amplify their voices and could be helpful to challenge the system. Hear the response.
Cathy and Dr. Rosenthal wrapped up the conversation on a note of hope for change and reform. “I tell everyone when I go talk to hospitals,” Dr. Rosenthal said, “just do something. Do something in whatever space you exist to start changing things because I think that’s how empowerment starts.”
You can listen to our entire conversation below:
For easy reference, from An American Sickness:
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.