An American Sickness

How Healthcare Became Big Business and How You Can Take It Back

By: Elisabeth Rosenthal

Narrated by: Nancy Linari

Length: 13 hrs and 38 mins

Publisher's summary

Award-winning New York Times reporter Dr. Elisabeth Rosenthal reveals the dangerous, expensive, and dysfunctional American health-care system and tells us exactly what we can do to solve its myriad of problems.

It is well documented that our health-care system has grave problems, but how, in only a matter of decades, did things get this bad? Dr. Elisabeth Rosenthal doesn't just explain the symptoms; she diagnoses and treats the disease itself. Rosenthal spells out in clear and practical terms exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship, explaining step by step the workings of a profession sorely lacking transparency. This is about what we can do, as individual patients, both to navigate a byzantine system and also to demand far-reaching reform.

Breaking down the monolithic business into its individual industries - the hospitals, doctors, insurance companies, drug manufacturers - that together constitute our health-care system, Rosenthal tells the story of the history of American medicine as never before. The situation is far worse than we think, and it has become like that much more recently than we realize. Hospitals, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Americans are dying from routine medical conditions when affordable and straightforward solutions exist.

Dr. Rosenthal explains for the first time how various social and financial incentives have encouraged a disastrous and immoral system to spring up organically in a shockingly short span of time. The system is in tatters, but we can fight back. An American Sickness is the frontline defense against a health-care system that no longer has our well-being at heart.

©2017 Elisabeth Rosenthal (P)2017 Penguin Audio

Critic reviews

"An eye opening discussion ... [An] important book.... Rosenthal told an interviewer her goal was to 'start a very loud conversation' that will be 'difficult politically to ignore.' We need such a conversation - not just about how the market fails, but about how we can change the political realities that stand in the way of fixing it.” (The New York Times Book Review)

“In this in-depth analysis of a malfunctioning system, Rosenthal makes a compelling case against the hospital and pharmaceutical executives behind the 'money chase,' and it’s hard to imagine a more educated, credible guide...The patients she interviewed share mind-boggling stories...She builds her case with one damning statistic after another...Rosenthal presents solutions both personal and societal in this commanding and necessary call to arms.” (Booklist [starred])

"Provocatively analyzes...Rosenthal unveils with surgical precision the 'dysfunctional medical market'...a startling cascade.” (Publishers Weekly [starred review])

Not well balanced

As a physician in a large healthcare system that has been given the job of increasing quality and lowering the total cost of care, I appreciate the calling out of many excesses and poor systems in our healthcare system. However, I felt that Dr. Rosenthal seemed to almost always assign a profit motive as the cause. There was almost always a judgement of the providers that did not fully explain the complexities of the given situation. For example, in a discussion of patient satisfaction and the resort like amenities at many hospitals, she summed up the reason as “CMS bonuses hospitals”. She fails to mention how small the “bonuses” are, that there are also penalties, and that the majority of hospitals get no bonus or penalty. She also fails to mention public expectations. I remember my patients refusing to go hospitals that had shared rooms. They wanted private rooms. Acting like hospitals added comfort amenities only to get a CMS bonus or to find ways to add charges is mostly inaccurate. This judgement and simple explanation is common throughout.
However, I applaud her efforts to call out the many excesses and suggest solutions. I wish that she had been less judgmental and not lumped all hospitals and physicians together with those who do have poor motives. The latter group is not small but it is also not the majority. Most of the problem is a system that drives many unintended consequences from people who do have good motives. I hope that her book will help us make positive changes in the US Healthcare system.

An incomplete picture of the US healthcare system

If you believe that the healthcare system used to be driven only by good intentions and care for patients and if you believe that currently the system is driven only by greed, then you will probably find this book extremely satisfying.

On the other hand, if you see that the current US healthcare system is complex and that desire for profit is only one element of that system, then you're probably going to spend a good deal of listening time thinking about all the information the author is excluding (seemingly because it doesn't support or add to her primary hypothesis). Hence, you may want to look for another book - or at least realize that you're only going to get a partial picture from this book.

Well Researched, Outlined, and Presented

This book captivated and held my interest from beginning to end. It was filled with relevant examples and anecdotes to help the reader understand the issues being addressed. Each chapter is well laid out and the order is very logical in its presentation. I love that the author constantly referred back to previous rules and guidelines throughout the entire book to help remind the reader of previously stated topics.

Rosenthal does not blame doctors or political sides in this book but rather points out all problems with our healthcare system. The portion where she describes what actions can be made to help improve our current heath care system are actually feasible. There was so much information in this book that was new to me and I feel like anybody that wants to learn more about our healthcare system should read this book.

I cannot say enough good things about this book. It is one of the best books I have read so far in 2017.

Must read for all Americans interested in health

There a great deal of information and history of how this mess of a health care system came to be. There are suggestions on how the evolution of a better system can be made. No one villain no quick fix everyone needs to be involved.

A Fascinating Must Read - Is it Onesided?

So much good and fascinating information in this book. I find it to be a must read for almost anyone over 30. We has patients need to be extremely diligent by taking as much control over our healthcare as possible and reasonable. It is not like the good old days when you just trusted everything the hospital and doctor told you and did to you.

Give how much good information is in this book - I did feel there as a major hole in that it was kind of one sided. When I spoke about some of the ideas in this book with some healthcare leaders I work with, they had some things to say that provided a different perspective. So just keep that in mind when reading.

Outstanding summary of our current healthcare situation

A must read for every American to better understand the issues stakeholders and patients face, how we got to this current situation, and why politicians are in a standoff over a solution that will work to keep cost down while providing high quality patient care. Very timely and a much needed release.

Every American Needs to Read This Book

I've known that the system is broken and corrupt, but didn't understand the full scope of the problem until now. Thank you for breaking down the issues and providing solutions that patients can start to implement now. I'm definitely going to be a different kind of patient.

Side effects may include switching cardiologists

A thoroughly researched and beautifully written analysis of the American health care system and why we pay so much more for so much less than any other industrialized nation. A must read for doctors and patients everywhere.

A quick read.

Is there anything you would change about this book?

Shorten it. Less anecdotal, more to the point. Solutions were shallow and/or just impractical." Question medical personnel that visit you in the hospital to determine the legitimacy of the hospital billing program? C'mon.

Would you ever listen to anything by Elisabeth Rosenthal again?

Sorry - no.

Would you be willing to try another one of Nancy Linari’s performances?

Oh, sure.

Who do you think would benefit most from listening to An American Sickness?

It would make a good pamphlet for someone that feels they need a "medical industry summary for dummies". Which absolutely described me. So, I was glad I went through it, once.

One of the most important books you'll read

Everyone needs to read this book, and urgently. It describes where and how the American healthcare industry has broken down, how that affects you, and what you can do about it, as an individual and citizen. I started putting this book into practice about halfway through and it has already changed my life. I listened to this book and now am going out to buy a print copy, worth every dime in hardcover, because I need to make copies of the pages of advice for going to a doctor, evaluating whether to get a test, etc. I will make copies of the relevant pages to have with me for time in the hospital, as a cheat sheet, to protect both my health and pocketbook.

The health care reality that Rosenthal describes is enraging, and something that I have experienced thankfully at lesser levels than some of the people described in the book. She explains everything thoroughly and clearly, and the book is written at a perfect pitch, sophisticated and yet not overly technical, illuminating the societal levels of the issues but also making them very practical. Best health advice you'll receiveall this year: get this book.