Author Topic: Rosenthal, AMERICAN SICKNESS: HOW HEALTHCARE BECAME BIG BUSINESS AND HOW YOU CAN TAKE IT BACK  (Read 49 times)

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Offline agate

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Elisabeth Rosenthal, AN AMERICAN SICKNESS: HOW HEALTHCARE BECAME BIG BUSINESS AND HOW YOU CAN TAKE IT BACK (2017)


This is what I posted on my book reviews blog:



This is a timely and important book. The author, who was a practicing physician for about 8 years before becoming the science and health reporter for the New York Times, seems to know her topic thoroughly.  She paints an alarming picture of the US healthcare system, with hospitals and medical providers and drug companies all helping themselves to considerable sums of money thanks to cleverness in manipulating insurance company and Medicare policies. It adds up to a catastrophically broken system, with patients being harmed and often impoverished by it.

She gives detailed descriptions of inventive forms of "strategic billing" used by doctors and hospitals who have devised ways of using the elaborate coding system to generate a far higher price tag for services and items that they should have. 

She has no use for direct-to-consumer drug advertising, which is now inundating the US media.

Then there are "surrogate endpoints." According to the National Cancer Institute Website, a surrogate endpoint is:


In clinical trials, an indicator or sign used in place of another to tell if a treatment works. Surrogate endpoints include a shrinking tumor or lower biomarker levels. They may be used instead of stronger indicators, such as longer survival or improved quality of life, because the results of the trial can be measured sooner. The use of surrogate endpoints in clinical trials may allow earlier approval of new drugs to treat serious or life-threatening diseases, such as cancer. Surrogate endpoints are not always true indicators or signs of how well a treatment works.


Rosenthal has this to say about them:

An in-depth data investigation by the Milwaukee Journal Sentinel and MedPage Today in 2014 revealed that, thanks to surrogate endpoints, 74% of cancer drugs approved by the FDA during the previous decade ultimately did not extend life by even a single day.

She discusses "accelerated approval measures"--the easiest way to get drug products onto the market. In this way companies can more easily market drugs and biologics that have no real proven value, she says.

She strongly favors obliging hospitals to make their chargemasters clearly available to all patients so that they can find out what they can expect to be charged for everything that is done during their hospital stays, and she would like to see hospitals guarantee that all doctors who treat you are in your insurance network--to avoid the very unwelcome surprise of a bill that is astonishingly higher than anticipated just because the doctor who examined or treated you was out-of-network.

She maintains that the skills of pharmacists in the US are very underused and points out that in Europe drugs are classified into three groups: over-the-counter, prescription, and pharmacist-dispensed.  Using pharmacists' training and knowledge by enabling them to dispense drugs without doctors' prescriptions would ease the burden on doctors and provide patients with readier access to many well-established drugs.

The book includes three useful appendices, with links to Websites where more information can be found.
« Last Edit: January 06, 2019, 07:01:58 am by agate »
MS Speaks--online for 12 years

SPMS, diagnosed 1980. Avonex 2001-2004. Copaxone 2007-2010.

 

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