Broke is the definition of every aspect of American medicine today

Regardless of whether you are for single-payer health insurance, fee for service, a hybridized French system, or the Affordable Care Act, what’s clear is that most of our health care system is broken. It’s left behind from the world of technology and creative destruction and it’s far too expensive.

It’s a system that is broken, and that increasingly places barriers to entry for those without knowledge of the system or the poor without the financial resources to access it.

But what about the doctors that work in such a system. How does it impact them, many of whom wanted to practice medicine not social work. Dr. Michael Stein looks a this in Broke: Patients Talk about Money with Their Doctor.

My conversation with Dr. Michael Stein

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Why Health Care Is Broken, and How to Fix It...Hint..Medicare for All is Not the Answer

Imagine if you went to buy a car and rather than one price for the car, you had to essentially buy it ala carte. You had to negotiate a separate price for the wheels, for the engine, for the paint, for seats, all separate. All from different suppliers and all with hidden fees. Sound ridiculous? But that is essentially how we pay for health care in America.

It’s no wonder that there is no more polarizing issues than the delivery and the cost of health care. It’s why it’s front and center in our politics, and in all of our lives. It’s a system that alone makes us sick.

It’s amazing how many people say they like their doctors, but hate the system. A system that is broken, has lost public trust and has become a business model in which price gouging is built-in, outcomes are not part of pricing, and it corrupts people who often start out as idealists.

This is the system that Dr. Marty Makary details in The Price We Pay: What Broke American Health Care--and How to Fix It.

My conversation with Dr. Marty Makary:

Can American Health Care Be Saved:

One thing the health care debate has taught us is that American medicine today is like snowflakes. No two are the same.

From the no wait privileges of concierge medicine, to the ERs and clinics in our poorest urban neighborhood, the medical experience is one of great diversity. Outcomes and wellness care are miles apart. This is unlike any other Western nation.

So what’s it like for a young compassionate doctor venturing into this world, and seeing the suffering, limitations and reality of medicine today?

That’s the story that Dr. Rachael Pearson tells in No Apparent Distress: A Doctor's Coming-of-Age on the Front Lines of American Medicine.

My conversation with Rachel Pearson:

Why Is American Health Care So Sick?

We’ve all heard the old adage that what can be done, can be undone. Well maybe we need to try that with our healthcare system.

In just fifty years we’ve gone from an affordable and human based system, to one that people hate at every level. They may like their individual doctors, but they generally hate the system.

Of course there has been change and disruptions everywhere in our society. But most of it has been to make our lives easier, better, more efficient and in many cases, to lower costs.

In healthcare, it’s become less efficient, costlier, less human centric, and the net result has not been to dramatically increase care or life expectancy. Instead it's enriched those at the top of the system while at the same time, being out of step with every system, in every other western nation. This is American exceptionalism of the very worst kind.

So how did we get here and is that knowledge useful in trying to fix it. Those are the issues that Dr. Elisabeth Rosenthal takes up in An American Sickness: How Healthcare Became Big Business and How You Can Take It Back.

My WhoWhatWhy.org conversation with Dr. Elisabeth Rosenthal:

American Healthcare: Spending more is getting us less

It’s amazing sometimes how simple ideas get lost in the big picture. Back in 1923, President Warren Harding proposed a federal department to look after the nation's health, education and welfare. The department was finally created by Eisenhower in 1953. In 1979, Education was spun off and we created the Department of Health AND Human Services.

Clearly as a nation, we’ve long understood the connection between health and human services. Yet the way our health care system has evolved, preventive care, and human services have been almost abandoned as part of the health care enterprise.

Today we spend more money, per capita, on health care than any other nation. Yet our outcomes, are near the bottom. How did this happen, especially when we seemed to understand all along that there was a connection?

Is the fault in our government, our doctors, in our philosophy or in ourselves? Elizabeth Bradley and Lauren Taylor set out to try and find out. The result is their book The American Health Care Paradox: Why Spending More is Getting Us Less

My conversation with Elizabeth Bradley and Lauren Taylor:

Deadly Spin

Before Congress thinks about tampering with the new health care laws, they need to take a close look at what former Cigna PR Executive Wendell Potter says about what's really going on inside the insurance industry. He was the very well respected former head of Corporate Communications for Cigna until his conscience led him to turn on his former colleagues and testify before Congressional Committees about what he viewed as the health-insurance industry's "duplicitous" behavior. He openly talks about how insurers would have no problems with "dumping the sick" to protect the stock price above all else. Now, Wendell Potter, in his book Deadly Spin: An Insurance Company Insider Speaks Out on How Corporate PR Is Killing Health Care and Deceiving Americans, gives us a true profile in courage.

My conversation with Wendell Potter:

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Health Care...Solved

As the past year will attest, if we wait for Washington to solve the health care crises, we could be waiting a very long time. Yet in spite of Washington, or maybe because so little gets done there, their are some real world efforts going on at the business and grass roots level that are transforming health care into a cost-efficient, accountable system that actually empowers consumers.

John Torinus, the CEO of Serigraph, in Milwaukee, Wisconsin, is truly at the leading edge of this effort. His commitment, his passion and encyclopedic knowledge of the subject has created a model that companies all over can follow. He's even written a book, The Company That Solved Health Care, to share his efforts.

My conversation with John Torinus Jr.

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