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kapbanana's review against another edition
4.75
Honestly, this book had me seriously questioning how our whole healthcare system isn't illegal. It's astounding the amount of greedy shenanigans that are going on. And absolutely infuriating.
alexisrt's review against another edition
5.0
Elisabeth Rosenthal's exploration of healthcare costs is a must read for anyone who is interested in why their premiums keep rising and their hospital bills convoluted.
We're all familiar with blaming insurance companies and drugmakers. But our system is much more complicated and problem ridden. The American healthcare system is a giant money trough, and providers, suppliers, payers, and consultants are lined up with their snouts buried. Providers inflate their costs; insurers pay it and pass it on. As soon as the payers--whether commercial insurers or Medicare--close one loophole, an army of consultants is lined up to find a new one. Your PCP may do an extra exam at a quick visit to justify billing as a Level 4 or 5 to maximize visit reimbursement. He may be pushed to send your labwork to the more expensive hospital lab, instead of Quest. Your local hospital network may be leveraging their brand name to charge more than its competitors. Even salaried doctors may have their salaries tied to billing, and as their practices are increasingly controlled by larger groups and healthcare systems, have their billing micromanaged to ensure revenue is maximized. The bulk of the book is devoted to exploring this and it's eye opening.
The solutions section is shorter, and for good reason: She doesn't have a ton to offer that wouldn't entail a giant overhaul of the health system. There are temptations here on both right and left. Conservatives will hail sections as proof of their "skin in the game" theory. For example, drug prices jumped after the introduction of Medicare Part D, because it's easier to squeeze money from the insurer. But as Dr. Rosenthal points out, when we're talking thousands of dollars, it's a kidney in the game, not skin. It doesn't matter to you if it's $75,000 or $45,000 for back surgery, because you can't pay for either one by yourself.
On the left, it's a demonstration of our need for single payer, but it's also a cautionary note. The payer is not the only problem, as the examples with Medicare show. The pay per procedure model derives from a formula devised by CMS. We need to change far more than who pays the bills. It's easy to talk about politicians who are in the pocket of insurers or pharmaceutical companies, but the scale of the changes we'd need to control costs and the effect they would have on the gigantic health care industry we've grown--with its attendant jobs--could scare a much more liberally minded politician.
She adds some tips that are meant to help you with your own bills, but they are of somewhat limited use (as I think she knows). For example, she suggests waiting rather than rushing for treatment, but you need to know when to do that. Or you should call your doctor rather than heading straight in for a visit, but since these are uncompensated care, your doctor may be unable or unwilling to do that. If you have limited medical choices in your area, her tips for learning more about cost won't help. They're not really terrible, but add only a small amount to the book.
We're all familiar with blaming insurance companies and drugmakers. But our system is much more complicated and problem ridden. The American healthcare system is a giant money trough, and providers, suppliers, payers, and consultants are lined up with their snouts buried. Providers inflate their costs; insurers pay it and pass it on. As soon as the payers--whether commercial insurers or Medicare--close one loophole, an army of consultants is lined up to find a new one. Your PCP may do an extra exam at a quick visit to justify billing as a Level 4 or 5 to maximize visit reimbursement. He may be pushed to send your labwork to the more expensive hospital lab, instead of Quest. Your local hospital network may be leveraging their brand name to charge more than its competitors. Even salaried doctors may have their salaries tied to billing, and as their practices are increasingly controlled by larger groups and healthcare systems, have their billing micromanaged to ensure revenue is maximized. The bulk of the book is devoted to exploring this and it's eye opening.
The solutions section is shorter, and for good reason: She doesn't have a ton to offer that wouldn't entail a giant overhaul of the health system. There are temptations here on both right and left. Conservatives will hail sections as proof of their "skin in the game" theory. For example, drug prices jumped after the introduction of Medicare Part D, because it's easier to squeeze money from the insurer. But as Dr. Rosenthal points out, when we're talking thousands of dollars, it's a kidney in the game, not skin. It doesn't matter to you if it's $75,000 or $45,000 for back surgery, because you can't pay for either one by yourself.
On the left, it's a demonstration of our need for single payer, but it's also a cautionary note. The payer is not the only problem, as the examples with Medicare show. The pay per procedure model derives from a formula devised by CMS. We need to change far more than who pays the bills. It's easy to talk about politicians who are in the pocket of insurers or pharmaceutical companies, but the scale of the changes we'd need to control costs and the effect they would have on the gigantic health care industry we've grown--with its attendant jobs--could scare a much more liberally minded politician.
She adds some tips that are meant to help you with your own bills, but they are of somewhat limited use (as I think she knows). For example, she suggests waiting rather than rushing for treatment, but you need to know when to do that. Or you should call your doctor rather than heading straight in for a visit, but since these are uncompensated care, your doctor may be unable or unwilling to do that. If you have limited medical choices in your area, her tips for learning more about cost won't help. They're not really terrible, but add only a small amount to the book.
kimball_hansen's review against another edition
3.0
3 stars not because it was bad but because some parts of the book wasn't as engaging as others. Partially because I am unfamiliar with many terms and other related items. But I loved learning the history of health care. It all started in Texas by the nonprofit Blue Cross Blue Shield. Now look what it's become. All of it. Earliest health insurance was designed to compensate for income lost during illness and sickness.
There were times while reading this book that it made my blood boil. I hate, absolutely hate, the industry of medicine and insurance (not to mention lawyers). A great majority of you are crooks while a great number of us Commoners have our hands tied. More specifically I hate the administration of these hospitals and medical industry. Some of the actual doctors are plain Ñembotavy which is just as bad.
I'm annoyed with the whole martyr attitude that doctors have when they try to justify their pay and say they earn less than plumbers or teachers. Yet the typical doctor is living in a mansion and million dollar home. I don't see common teachers, plumbers, or others in that industry doing that.
Those debts that the author rattled off seem a little low.
I didn't realize there were that many coder jobs (not programming).
There's strategy in buying medicine or getting a procedure done in a foreign country and that difference could even pay for the airfare itself.
There are lots of good resources in the appendix of this book. Worth to have a hard copy.
Even if this book was majorly bias (unbeknownst to me) I think Americans should read it to help open their eyes and stop going with the flow.
I'm just glad that you don't get penalized for not having health insurance now. Stupid ObamaCare.
There were times while reading this book that it made my blood boil. I hate, absolutely hate, the industry of medicine and insurance (not to mention lawyers). A great majority of you are crooks while a great number of us Commoners have our hands tied. More specifically I hate the administration of these hospitals and medical industry. Some of the actual doctors are plain Ñembotavy which is just as bad.
I'm annoyed with the whole martyr attitude that doctors have when they try to justify their pay and say they earn less than plumbers or teachers. Yet the typical doctor is living in a mansion and million dollar home. I don't see common teachers, plumbers, or others in that industry doing that.
Those debts that the author rattled off seem a little low.
I didn't realize there were that many coder jobs (not programming).
There's strategy in buying medicine or getting a procedure done in a foreign country and that difference could even pay for the airfare itself.
There are lots of good resources in the appendix of this book. Worth to have a hard copy.
Even if this book was majorly bias (unbeknownst to me) I think Americans should read it to help open their eyes and stop going with the flow.
I'm just glad that you don't get penalized for not having health insurance now. Stupid ObamaCare.
sprucetree520's review against another edition
5.0
This is the most infuriarting book and for once it wasn't due to the authors choice. This is a book that every person should have on their book shelfs both for the guidance and the for the information on how thou roughly we are being fucked. Define toy will be referencing this book in the future