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A review by ddrake
Never Pay the First Bill: And Other Ways to Fight the Health Care System and Win by Marshall Allen
3.0
I skimmed through this, because (1) I am one of those fantastically lucky and rare Americans with very good health insurance and who has had generally good experiences with the health care system, and (2) I've read a lot of similar books, which I recommend, including [b:An American Sickness: How Healthcare Became Big Business and How You Can Take It Back|31253737|An American Sickness How Healthcare Became Big Business and How You Can Take It Back|Elisabeth Rosenthal|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1474748641l/31253737._SY75_.jpg|51910639] and [b:The Price We Pay: What Broke American Health Care--and How to Fix It|42373033|The Price We Pay What Broke American Health Care--and How to Fix It|Marty Makary|https://i.gr-assets.com/images/S/compressed.photo.goodreads.com/books/1541327050l/42373033._SY75_.jpg|66030241] (and other books by [a:Marty Makary|5786795|Marty Makary|https://images.gr-assets.com/authors/1348665517p2/5786795.jpg]).
What sets this book apart is that it is a very good, concrete how-to manual.
This book did prompt the following thought experiment: Allen documents how the health care system is often either indifferent or overtly hostile to patients. You get a bill that's totally incorrect? Oh well, the hospital billing person says, that happens. Or the hospital or insurance company threatens a patient who is disputing a bill.
Let's think incentives. Why do people in the health care system act like this? It's because their incentive is to maximize revenue for the hospital, insurance company, pharmacy benefits manager, or so on. Their first duty is to the revenue and profitability of their little piece of the health care system. Helping a patient with a bill doesn't always fulfill that duty.
What would happen if the system was the other way around? What would happen if you had a health care system that actually, truly focused on patients and their financial interests?
The typical wisdom is that you'd go broke. You -- a hospital, clinic, etc -- need to pay those doctors and nurses and buy the medical supplies and so on. So you gotta pay attention to your revenue. But how far could we push against that? I don't have any good answers, and surely the American health care system isn't going to go anywhere in that direction, but I do wonder.
Allen documents
What sets this book apart is that it is a very good, concrete how-to manual.
This book did prompt the following thought experiment: Allen documents how the health care system is often either indifferent or overtly hostile to patients. You get a bill that's totally incorrect? Oh well, the hospital billing person says, that happens. Or the hospital or insurance company threatens a patient who is disputing a bill.
Let's think incentives. Why do people in the health care system act like this? It's because their incentive is to maximize revenue for the hospital, insurance company, pharmacy benefits manager, or so on. Their first duty is to the revenue and profitability of their little piece of the health care system. Helping a patient with a bill doesn't always fulfill that duty.
What would happen if the system was the other way around? What would happen if you had a health care system that actually, truly focused on patients and their financial interests?
The typical wisdom is that you'd go broke. You -- a hospital, clinic, etc -- need to pay those doctors and nurses and buy the medical supplies and so on. So you gotta pay attention to your revenue. But how far could we push against that? I don't have any good answers, and surely the American health care system isn't going to go anywhere in that direction, but I do wonder.
Allen documents