“An American Sickness:” News We Can Use

I don’t know anyone who isn’t distressed these days about the state of our American healthcare system, and the uncertainties about its future. We may hold differing opinions about what needs to be done to solve skyrocketing healthcare costs and unequal access to services, but what we all share is the worry: worry that we or our loved ones might, at any moment, be faced with an urgent health care need we won’t have the resources to meet, or insurance that we will no longer be able to afford, or that proposed new legislation (this seems to change daily) will allow insurers to once again refuse to cover the conditions for which we most need coverage in the first place.

In fact, many if not most of us have some kind of horror story already: maybe about being surprised by a six-figure bill for an emergency surgery procedure for which our insurance denied coverage (or for which we were uninsured); maybe we have our own equivalent of the “$2000 Bandaid” story in which a patient’s insurer was charged $2000 for an emergency room application of a Bandaid to a cut finger (the patient’s portion for the Bandaid was $200).

And when I say “I don’t know anyone who isn’t distressed,” I include myself. Maybe, like me, a large part of your distress has been a result of the belief (for me until recently) that it is all too enormous and complicated a problem to understand. Which belief has left many of us feeling helpless, bewildered and frustrated, with no clear sense of how to take effective action. Leaving us, in short, both stressed and distressed.

As you may remember from my previous columns, “stress” itself is actually a normal part of living, and not actually a problem. In fact, we need stress to motivate us to solve problems (“stress” is the feeling that lets us know that there even is “a problem”!), and it is stress that triggers the body’s immune system to attack viruses and bacteria. But stress becomes distress in the absence of the information, means, or motivation to take the kind of action that allows us to respond effectively to the “signal” of stress…and it is persistent distress that hurts our health.

So recently, when some friends gave me a copy of An American Sickness (subtitle: “How Healthcare Became Big Business and How You Can Take it Back”),  I was initially hesitant to even open the book, afraid (I admit) of simply feeling even more overwhelmed by the scale and scope of the healthcare mess than I already felt.

410kNvpsHYL._SX327_BO1,204,203,200_But since the book had been a gift, I thought I owed our friends the courtesy of at least starting it, so that I could say I’d tried to read it…

So I did start reading… and soon found myself reading…and reading…and reading. I am so glad I did.

Written by Dr. Elizabeth Rosenthal, who is both an MD and a long-time New York Times journalist, An American Sickness is a fascinating explanation (which reads like an exceptionally detailed “whodunit” ) of how the American health care system –which is made up of hospitals, insurance companies, physicians and drug companies– has gone from where it started (as a caring, not-for-profit industry with patients’ best interests at heart) to where it is today (a highly profitable, basically unregulated industry pursuing maximum profits at patients’ expense). 

While the details contained in the book are not likely to put any reader at greater ease, still, knowledge is power. For me, just having so much clearer an understanding of where we are and how we got here has been an antidote to my distress, by providing the information necessary to take action (instead of just feeling “reaction”), as a patient and as a citizen.HCCH_HDR

The thing is, the American healthcare system is one big machine, with many interlocking and interdependent parts. And as any mechanic knows, understanding how the machine works is the first step in figuring out how to work on it. Happily, this book includes sections at the end with concrete tools for ways that we as individuals can do just that, whether that be at the level of political lobbying, or when signing agreements or questioning charges regarding personal health care…since (as Rosenthal points out), a lot of the overcharging that goes on, goes on because it remains unquestioned and undisputed, including by consumers.  


As described in the book jacket,

This is about what we can do, as individual patients,

both to navigate the maze that is American healthcare

and also to demand far-reaching reform.

But don’t take my word for it— give it a read! Widely available through library systems, your local, independent bookstore, and (if you must:) online.