"How U.S. Health Care Became Big Business": Medical Journalist, Dr. Elisabeth Rosenthal talks with NPR's Terry Gross

"How U.S. Health Care Became Big Business": Medical Journalist, Dr. Elisabeth Rosenthal talks with NPR's Terry Gross

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"How U.S. Health Care Became Big Business": Medical Journalist, Dr. Elisabeth Rosenthal talks with NPR's Terry Gross

Audio (36 minutes) & Transcript: npr.org/templates/transcrip...

Found this discussion about how the American Health Care System evolved to its current state very interesting.

May be of interest to you too? 🤔

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🙏 🌺 🍀 🌞

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  • [Part 1 of 2]

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    Article from: npr.org/sections/health-sho...

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    How U.S. Health Care Became Big Business

    Health care is a trillion-dollar industry in America, but are we getting what we pay for? Dr. Elisabeth Rosenthal, a medical journalist who formerly worked as a medical doctor, warns that the existing system too often focuses on financial incentives over health or science.

    "We've trusted a lot of our health care to for-profit businesses and it's their job, frankly, to make profit," Rosenthal says. "You can't expect them to act like Mother Teresas."

    Rosenthal's new book, An American Sickness, examines the deeply rooted problems of the existing health-care system and also offers suggestions for a way forward. She notes that under the current system, it's far more lucrative to provide a lifetime of treatments than a cure.

    "One expert in the book joked to me ... that if we relied on the current medical market to deal with polio, we would never have a polio vaccine," Rosenthal says. "Instead we would have iron lungs in seven colors with iPhone apps."

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  • [Part 2 of 2]

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    INTERVIEW HIGHLIGHTS

    On what consolidation of hospitals is doing to the price of care

    In the beginning, this was a good idea: Hospitals came together to share efficiencies. You didn't need every hospital ordering bed sheets. You didn't need every hospital doing every procedure. You could share records of patients so the patient could go to the medical center that was most appropriate.

    Now that consolidation trend has kind of snowballed and skyrocketed to a point ... that in many parts of the country, major cities only have one, maybe two, hospital systems. And what you see with that level of consolidation is it's kind of a mini-monopoly.

    What happens, of course, when you have a mini-monopoly is you have an enormous sway over price. And so, what we see in research over and over again is that the cities that have the most hospital consolidation tend to have the highest prices for health care without any benefit for patient results. So consolidation, which started as a good idea in many places, has evolved to a point where it's not benefiting patients anymore, it is benefiting profits.

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    On the ways the health-care industry stands to profit more from lifetime treatment than it does from curing disease

    If you're a pharmaceutical manufacturer and you have a problem like diabetes, for example, if I invented a pill tomorrow that would cure diabetes — that would kill a multi-billion dollar business market. It's far better to have treatments, sometimes really great treatments ... [that] go on for life. That's much better than something that will make the disease go away overnight.

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    On how prices will rise to whatever the market will bear

    Another concept that I think is unique to medicine is what economists call "sticky pricing," which is a wonderful term. It basically means ... once one drugmaker, one hospital, one doctor says "Hey we could charge $10,000 for that procedure or that medicine." Maybe it was $5,000 two months ago, but once everyone sees that someone's getting away with charging $10,000, the prices all go up to that sticky ceiling. ...

    What you see often now is when generic drugs come out ... the price doesn't go down to 20 percent of the branded price, it maybe goes down to 90 percent of the branded price. So we're not getting what we should get from a really competitive market where we, the consumers, are making those choices.

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    On initiating conversations early on with doctors about fees and medical bills

    You should start every conversation with a doctor's office by asking "Is there a concierge fee? Are they affiliated with a hospital? Which hospital are they affiliated with? Is the office considered part of a hospital?" In which case you're going to be facing hospital fees in addition to your doctor's office fees. You ask your doctor always ... "If I need a lab test, if I need an X-ray, will you send me to an in-network provider so I don't get hit by out-of-network fees?" ...

    Often that will be a little hard for your doctor, because they may have to fill out a different requisition, but it's worth asking. And any doctor who won't help you in that way, I think, isn't attuned to the financial cost that we're bearing today.

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    On getting charged for "drive-by doctors" brought in by the hospital or primary doctor

    You do have to say "Who are you? Who called you?" and "Am I going to be billed for this?" And it's tragic that in recovery people have to think in this kind of keep-on-your-guard, somewhat adversarial way, but I think if we don't push back against the system in the way it bills, we're complicit in allowing it to continue.

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    On how to decipher coded medical bills

    Don't be alarmed by the "prompt payment discount." Go back to the hospital and say, "I want a fully itemized bill. I want to know what I'm paying for." Some of it will be in codes, some of it will be in medical abbreviations. I've discovered you can Google those codes and find out what you're being charged for, often, and most importantly, you might find you're being charged for stuff that obviously you know you didn't have.

    Elizabeth Rosenthal is editor-in-chief of Kaiser Health News, an editorially independent news program of the Henry J. Kaiser Family Foundation and a partner of NPR's. Neither KFF nor KHN is affiliated with Kaiser Permanente. Radio producer Sam Briger and web producers Bridget Bentz and Molly Seavy-Nesper contributed to this story.

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  • I don't listen to NPR anymore. Back during the Gulf War, 2 of our Military were taken prisoner, video taped, tortured, beaten and murdered.

    The morning after as I lay in the bed, I listened to a female NPR reporter describe our two brave heroes as having "passed away during the interrogation process"!

    NPR who receives our tax dollars should be refunded as a Liberal Propaganda Machine.

    Their reporting is always slanted. I wouldn't believe a word they say.

    Alice

  • Very sorry to hear that, A-Faye/ Alice, both about your 2 military people & your assessment of NPR. 🙏 😔

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    Yes, perhaps all reporting leans to one direction or another to some degree. 🤔 Yet, to "throw the baby out with the bath water" would pretty much leave us with no sources of information at all? 🤔

    Appears 'we've got what we've got' & just have to try & make the most of it? 🤔

    Guess we have to use our own judgement ⚖ to assess what seems probable/ likely & what make sense based on what we experience/ witness? 🤔

    Think we're all in the same boat on that front — 'trying to make sense of what we hear'. 🤔

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    ______

    Medical Journalist, Dr. Elisabeth Rosenthal, seems well-informed, reputable, reliable as an unbiased source? 🤔

    I'm not seeing bias or finding fault with her assessments.

    Perhaps you can share/ clarify the problematic points in her report that you're noticing so that we can re-evaluate/ reframe what we're hearing? 👍 Any clarifications would be much appreciated. 🙏 👍

    Thank you kindly, A-Faye/ Alice. 🙏 🌺 🍀 🌞

  • That's DEfunded.

  • Kai,

    As I had surmised, NPR pulled a fast one again. And, by the way, "my" executed soldiers were yours too, if you are an American.

    Dr Rosenthal is a physician,no longer practicing so she shouldn't use Dr. She was a "part time" ER doc who quit pretty quickly as she either wasn't smart enough, good enough or couldn't take the heat- or maybe all three.

    She is a leftist journalist who worked abroad for years so that gives her Euro Leftist credentials.

    She is editor in chief of a network that has no doctors on its staff or National Advisory Committee and whose contributing staff is a Who's Who of D.C. Lobbyists, leftists, environmentalists and former MSNBC and Politico hacks. She is not there to help sick patients, she is there to tear down and casts aspersions on the Real Doctors, pharmacists and medical institutions that are trying to help all of us suffering from this dreadful disease. We all need to be educated consumers and be smart about the people who are talking to us. Don't be used to spread their agendas. OH- she was just plugging her new book- not helping you and me with any genuine info other than ' be sure and ask if you're being charged'-duh.

    Here is her own bio on the KHN WEBSITE:

    "Editor-in-Chief, joined KHN in September 2016 after 22 years as a correspondent at The New York Times, where she covered a variety of beats from health care to environment to reporter in the Beijing bureau. While in China she covered SARS, bird flu and the emergence of HIV/AIDS in rural areas. Libby’s 2013-14 series “Paying Till it Hurts” won many prizes for both health reporting and its creative use of digital tools. Her book, “An American Sickness: How Healthcare Became Big Business And How You Can Take it Back,” is being published by Penguin Random House in April 2017. She is a graduate of Stanford University and Harvard Medical School and briefly practiced medicine in a New York City emergency room before converting to journalism."

    Even the above isn't true- she was a journalist, then a part time doctor for a couple of years, then a journalist again.

    * Kaiser Health News
1330 G St. NW
Washington, DC 20005
(202) 347-5270

    Alice

  • Oh, beg pardon, A-Fay/ Alice. 🙏

    Appears I misinterpreted phrase "2 of our Military were taken prisoner".

    Think my mind automatically 'filled in' ('jumped to' incorrect conclusion) that you were in the military & these 2 soldiers were in your group. (Beg pardon. 🙏 )

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    _____

    Sounds like you've kindly taken time to research Dr. Rosenthal & have a low opinion of her based on your research.

    In her audio discussion/ interview though, are there specific problematic points she raises, which are incorrect that you could elaborate on? Clarify for us?

    I understand, your disregard for Dr. R. as a reliable/ reputable source, but are there any nuggets of truth in what she's saying or is it all hogwash to be completely disregarded?

    Perhaps, if you've time/ interest, you can share/ clarify the problematic points in the interview? This could help us re-evaluate/ reframe/ 'put into context' what we're hearing for a more balanced perspective.

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    _____

    Any clarifications would be much appreciated. 🙏

    Also, could you share which resources you consider reputable, reliable sources of information so we may explore those as well?

    Always appreciate hearing multiple viewpoints in the hope of achieving a more balanced, well-rounded perspective. 🙏

    Thank you kindly, A-Faye/ Alice. 🙏 Much, much appreciate your generously taking time to share your views & research. 🙏 🌺 🍀 🌞

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