I felt outraged reading “The price we pay” by Marty Makary, MD

I recently relocated from Asia to the US. Before coming here, I knew that healthcare in the US was expensive. But that was only a concept in my head; I didn’t experience it firsthand yet. 

Now that I have been in the US for more than one year, experiencing the outrageous insurance premium (more than 4X what we paid in Singapore) and the price of typical over-the-counter drugs or regular clinic services, I feel the need to understand more about the healthcare system in the US. This led me to read two books: “The price we pay” and “Never pay the first bill.”

This post is about what I think of “The price we pay” by Dr. Marty Makary, MD. 

Dr. Marty Makary is a surgeon and public policy researcher at Johns Hopkins University. The price we pay is a New York Times best-selling book. 

Overall, it is a must-read for anyone who lives in the US. The book is full of real-life examples of how the healthcare system (specifically the middlemen, pharmacy benefit managers aka PBM, the hospitals, the insurance broker, etc.) takes advantage of people like you and me. The markup, kickbacks, and arbitrary nature of how they do pricing are outrageous. The markups can be 20 times, or even 50 times or more. 😐

You wouldn’t believe these stories because they are so unbelievable! It is no wonder that the US last year spent 18.3% of its GDP on healthcare. 

OECD data shows that the US spends more on healthcare per capita than any other advanced economy.

health spending per capita amongst OECD countries in 2021

The book is easy to read and includes specific actions that ordinary people like you and me can take to improve our healthcare situation. For example, don’t get bullied by the hospital billing departments or collection agencies. Hospitals are supposed to charge a “fair” price for service rendered, not an arbitrary price out of thin air. Fight them if you happen to fall into that situation. 

We want “honest medical care at an honest price.” That is a line in the book. But the current situation is so far from it. 

High healthcare cost is also why your take-home salary is not improving much. The company needs to take money out to pay for insurance premiums. T.T

This book is also written to address doctors, hospital owners, legislators, insurance companies, etc. 

The game has been going on for too long, and a fresh start is needed to fix the system. Makary suggests specific steps/solutions that government agencies, hospitals, doctors, and other players can take, including providing price transparency, collecting data to identify doctors who recommend the wrong solutions to patients and more. 

Doctors need to be armed with data about how their recommended treatment/course of action is against the norms in the industry, either nationwide or in their state. If they are a clear outlier, it will motivate them and their patients, the hospital, to look deeper and see if their recommended treatment makes sense. Or this is a case of over-treatment, over-care, or simply that someone wants to go home early on Friday, so he suggests a C-section for any woman in labor, whether they need it or not. 

Overall, The Price We Pay: What Broke American Health Care and How to Fix It is an insightful and comprehensive look at the current state of health care in the United States. Makary provides a thorough examination of the various factors that contribute to the high cost of health care, as well as the potential for reform. This review won’t do the book justice, so I highly recommend it.  


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