The Price We Pay

Marty Makary MD, 马蒂·马卡里

出版时间

2019-09-10

ISBN

9781635574111

评分

★★★★★
书籍介绍
From the New York Times bestselling author of Unaccountable comes an eye-opening, urgent look at America's broken health care system--and the people who are saving it. "A must-read for every American." --Steve Forbes, editor-in-chief, FORBES One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr. Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research, and his own experience, The Price We Pay paints a vivid picture of price-gouging, middlemen, and a series of elusive money games in need of a serious shake-up. Dr. Makary shows how so much of health care spending goes to things that have nothing to do with health and what you can do about it. Dr. Makary challenges the medical establishment to remember medicine's noble heritage of caring for people when they are vulnerable. The Price We Pay offers a roadmap for everyday Americans and business leaders to get a better deal on their health care, and profiles the disruptors who are innovating medical care. The movement to restore medicine to its mission, Makary argues, is alive and well--a mission that can rebuild the public trust and save our country from the crushing cost of health care.
精彩摘录
  • "一项大型牙科学研究发现,氟化氨银滴剂能预防龋齿。医生可以视需要重复给药,而不必在患者的牙齿上钻孔并置入填充物。让牙齿颜色变深是它唯一的副作用,多次反复使用甚至可能让牙齿变黑。"
作者简介
Marty Makary, MD, MPH, is a surgeon and Professor of Health Policy at Johns Hopkins University and the author of the New York Times bestseller, Unaccountable. A leading voice for physicians in the Wall Street Journal and USA Today, he was the lead author of the articles introducing a surgical checklist, later adapted by the W.H.O. and has published extensively on health care costs, vulnerable populations, and quality science. He served in leadership at the W.H.O. Safe Surgery Saves Lives project and has been elected to the National Academy of Medicine. He lives in the Washington DC area.
用户评论
[有声书] 倾情安利,尤其是对美国医疗费用高企问题感兴趣的人,很值得一读/听!会发现美国整个医疗系统都跟做生意没什么区别了,“占便宜赚钱”的不仅是部分医生做不必要的手术和检测和部分医院乱喊价、把付不起医疗费的病人告倒破产潦倒甚至直接进入人家的养老金账户扣钱,更是各个中间商,面向不同对象(个人或者企业)的broker不卖最适合的只卖自己回扣最多的… 关于医生在所学所应用的内容的反思,以及对医生个人评价数据分享的推广,都很有意思。有声书由作者自己演绎,声情并茂!对个人的建议的话,那就是如果可以的话一定要在看医生之前货比三家;如果是自己开公司的话,也很需要多比较才行。
摆的事实和数据乍一看都太魔幻了以至于很难相信…HORRIBLE! (不过大概是因为科普的性质 这本书真的很简单好读
经历美国医疗系统的各种问题的,想要骂美国医疗体系的,这本很推荐。John Hopkins 医学院外科医生+医疗政策研究者从过度检查,乱收费不透明收费,医院购买,雇主购买保险,药房pbm项目的过多中间人层层加价,到不靠谱的保健项目,医学院教学的弊病,全都说的深入浅出。还提供了一些医疗服务行业的”特斯拉”企业。学到很多有用的知识。
这本书,保证你看了气得吐血。其实美国医疗系统中各种恶心人很ridiculous的事情也不是没经历过,不止一次即使做手术之前反复确认,还是在事后被告知当天的麻醉师out of network不好意思请你付没有折扣的全款,如果你有精力有时间去闹,那可能给你个折扣。即使这样,作者披露的各种漫天要价,过度治疗,中间人吃大额回扣,医院开出天价账单并且立马上诉本来就穷困潦倒的病人,甚至导致病人一夜间破产信用受到深远影响,等等等等为了钱违背良知的操作。这还是神圣的医疗行业吗?好在,作者也讲述了一些有良知的医疗界人士在尝试着打翻这病态有毒的系统的故事。
美国医疗系统的昂贵没什么令人惊讶的,但是昂贵背后竟然存在这么多没有道德的商业操作(过度医疗、十几倍加价、起诉患者)还是让人很开眼。作为普通的消费者,建立自己的医疗常识(医生的话要信但不能盲从),了解自己的医疗保险,保持良好的生活方式都很重要。
讲了很多医疗行业的问题,但是讲的很乱,包括供应商/药企,GPO,医疗机构,医生,保险,保险经纪人,商业的救护飞机(?),雇主,法律,医生的绩效考核等等都有这种那种的问题。看到有评论说商业就是靠不对称性赚钱,但是现在是反过来为了赚钱强行制造制造不对称性。作者在书里只是说了有这种那种的现象,但是没有探讨为什么会这样,是因为大家越来越纵向发展之后的必然性嘛?如果一整个流程本身就有问题,那单纯的要求在每个流程阶段的人不能收kickback其实只是在尝试将不合规的东西洗白罢了
[Audible] Ultimately it makes no sense to me when the whole healthcare experience comes down to saving people's life physically and then ruining people's life financially... and the system sucks out the wages of normal people and the global completeness of big and small businesses (except the healthcare sector; rather, it creates so many 'jobs'! ).
facts都没问题,只是marty医生是要从政吗?书里处处“虽然我们问题重重,但美国是个伟大的国家,我和我的团队提出了伟大的解决方案,现在一切都变得很美好”甚至包括“不能让美国的供应链落入旁国比如中国导致我们一次医疗事故死了100人”??? 相当在理的部分是这是个系统性entrenched的问题&没有一个silver bullet可以一竿子解决(但是大家都喜欢找一个靶子好像处理了这个一切就好了呵呵呵)。 不管是教育还是医疗还是金融,为什么总是要消费者去自我教育小心挑选,而无法从根本上解决问题源头?
开眼界了
虽然已经听说过身边太多的高价医疗费,但是还是被书里的那些例子震惊。作者讨论了美国医疗的各个方面,比如高价医疗帐单、医疗器械药物回扣、过度医疗等,不过令人惊喜的是已经有机构组织和像作者一样的advocators正在改变现状。最大的体会是包括我自己非常害怕去医院之后的天价账单以及和保险公司的斗智斗勇,医疗体系不应该是这样的
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