Catastrophic Care – How American Health Care Killed My Father – And How We Can Fix It

Catastrophic Care – How American Health Care Killed My Father – And How We Can Fix It

By

David Goldhill

Infections from a hospital stay killed David Goldhill’s father in 2007, one of more than 200,000 deaths annually caused by medical error.  The medical bill was huge and fully paid by Medicare.  David wanted to know why it happened and why a business was paid after such a colossal error.  This would not happen in a market driven business.  This book is the result of Mr. Goldhill’s quest for answers.

The major premise of Mr. Goldhill’s book is that the patient is not the customer.  The actual customers are what he calls “surrogates” and these are private insurers, Medicare and Medicaid.  All of these are institutions begun with the best of intentions that have grown into unwieldy, inefficient behemoths over the last 45 years and have established a culture in our Health Care arena that is going to be difficult to change.

Originally, health insurance was in place to take care of “catastrophes” and not the common cold or the equivalent.  We have turned an insurance into a “payment mechanism” over the years.

The “surrogates” have become the consumers and are driving the market. They are profit driven, not market driven and have created a 3rd party administration that continues to drive up the price of health care and not the efficiencies.  The “Surrogates” along with the pharmaceuticals operate with a unique set of rules and, ironically, the higher premiums are, the higher the profits.  Medical costs go up [not down as in true competition], premiums go up, profits go up, and the true consumer [the patient] suffers from increasing costs.

In a true market scenario, prices drop and things become better and/or more efficient.  The most obvious analogy is computers.  The first laptops were thousands of dollars; you can now buy a better one for about $350.00.  Lasik surgery and most cosmetic surgeries prices drop because of competition.  Why?  They are not covered by insurance, thus no surrogates.

We, as the patients, have come to accept the status quo.  We go crazy when a gallon of gas rises by 10 cents, however, just accept the fact that medical procedures continue to escalate because the surrogates are in control and we are just paying the deductibles.  The surrogates benefit from rising prices.

So, what about the Affordable Care Act [Obamacare or ACA]?  More of the same.  We need to create a new system that is not procedure driven, is a true marketplace and is driven by the true customer, the patient.  This will take a minimum of a generation; however, it can be done.

Mr. Goldhill presents a possible scenario that places the patient in control and promotes transparency in costs in the medical field.  His suggestion is a combination of a very high deductible in true catastrophic insurance, health accounts and health loans.  I am not sure if that is the answer, but he presents a convincing argument and makes it very clear that the present situation in health care is unsustainable.

My suggestion is that you read this well-written and well researched book and get your legislators to do the same.  Thanks to Mr. Goldhill for presenting such a well articulated case in a tremendously complex situation.

Thanks for reading,

Mike