It's Enough to Make You Sick

The Failure of American Health Care and a Prescription for the Cure

Jeffrey M. Lobosky

More and more Americans are finding themselves without health insurance or with coverage that is so inadequate they face financial ruin in the event they actually get sick. So they go without. Their children don't receive their immunizations. They allow that worrisome lump in their breast to grow so large that by the time the cancer has been detected it has spread beyond the ability to cure. Seniors can't pay their heating bills or sustain adequate nutrition as the rising cost of their prescription drugs compels them to make difficult choices. Just how did our system become so dysfunctional and who is responsible? This book will tell you.

Too often, discussions on the health care crisis focus a myopic lens on the usual suspects. We are all quick to point a finger at insurance companies who place profit over patients or the pharmaceutical industry that extorts obscene amounts of American dollars for the same drugs that cost 50 to 75 percent less when we cross our borders north or south. We blame trial lawyers who practice with a "lottery" mentality that protects neither the patient from negligent care nor good physicians from frivolous lawsuits.

But the culpability for our crisis is more widespread. Hospitals have devolved from not-for-profit, community-based institutions to large, national for-profit chains. Doctors no longer spend time with their patients but instead rely on expensive, and often times, unnecessary tests and use physician extenders (such as P.A.s and nurse practitioners) to move patients along like cars on an assembly line. Politicians pass well-meaning laws as a knee-jerk reaction to a specific issue without understanding the unexpected consequences, which frequently only exacerbate the problem. And they operate in a system of special interests and influence peddling that all but assures the failure of any meaningful health care reform. And while we all demand high quality health care, few actually take preventative measures that could keep them out of the system they deride. This is a public that eats, drinks, and smokes to excess yet exercises far too seldom.

It's Enough to Make You Sick: The Failure of American Health Care and a Prescription for the Cure discusses how things got so bad, tracking the origins of the U.S. health care system and illuminating how each of the important components have evolved over the last century. Lobosky explains how the varied special interests have conspired to create a system that is by far the costliest in the world and yet is mediocre at best in providing quality care. He explores the various culprits and how each has contributed to the sad state of affairs. The Patient Protection and Affordable Care Act is dissected in detail, and a practical and compassionate blueprint for meaningful reform is offered to remedy the situation. This book is a must read for every American who is frustrated and disheartened by the recent health care battles, for every American who suffers through the "best health care system in the world," and for every American who wants to assure quality care for themselves and those they love.

Rowman & Littlefield Publishers

Pages: 284 • Trim: 6¼ x 9⅛

978-1-4422-1462-0 • Hardback • April 2012 • $27.00 • (£19.99) - Currently out of stock. Copies will arrive soon.

978-0-8108-9584-3 • Paperback • December 2017 • $29.00 • (£19.99)

978-1-4422-1464-4 • eBook • April 2012 • $27.50 • (£19.99)

Subjects: Health & Fitness / Health Care Issues, Medical / Caregiving, Political Science / Public Policy / General, Medical / Health Care Delivery, Medical / Health Policy, Business & Economics / Insurance / Health

It's Enough to Make You Sick

The Failure of American Health Care and a Prescription for the Cure

Hardback

Paperback

eBook

Summary

More and more Americans are finding themselves without health insurance or with coverage that is so inadequate they face financial ruin in the event they actually get sick. So they go without. Their children don't receive their immunizations. They allow that worrisome lump in their breast to grow so large that by the time the cancer has been detected it has spread beyond the ability to cure. Seniors can't pay their heating bills or sustain adequate nutrition as the rising cost of their prescription drugs compels them to make difficult choices. Just how did our system become so dysfunctional and who is responsible? This book will tell you.

Too often, discussions on the health care crisis focus a myopic lens on the usual suspects. We are all quick to point a finger at insurance companies who place profit over patients or the pharmaceutical industry that extorts obscene amounts of American dollars for the same drugs that cost 50 to 75 percent less when we cross our borders north or south. We blame trial lawyers who practice with a "lottery" mentality that protects neither the patient from negligent care nor good physicians from frivolous lawsuits.

But the culpability for our crisis is more widespread. Hospitals have devolved from not-for-profit, community-based institutions to large, national for-profit chains. Doctors no longer spend time with their patients but instead rely on expensive, and often times, unnecessary tests and use physician extenders (such as P.A.s and nurse practitioners) to move patients along like cars on an assembly line. Politicians pass well-meaning laws as a knee-jerk reaction to a specific issue without understanding the unexpected consequences, which frequently only exacerbate the problem. And they operate in a system of special interests and influence peddling that all but assures the failure of any meaningful health care reform. And while we all demand high quality health care, few actually take preventative measures that could keep them out of the system they deride. This is a public that eats, drinks, and smokes to excess yet exercises far too seldom.

It's Enough to Make You Sick: The Failure of American Health Care and a Prescription for the Cure discusses how things got so bad, tracking the origins of the U.S. health care system and illuminating how each of the important components have evolved over the last century. Lobosky explains how the varied special interests have conspired to create a system that is by far the costliest in the world and yet is mediocre at best in providing quality care. He explores the various culprits and how each has contributed to the sad state of affairs. The Patient Protection and Affordable Care Act is dissected in detail, and a practical and compassionate blueprint for meaningful reform is offered to remedy the situation. This book is a must read for every American who is frustrated and disheartened by the recent health care battles, for every American who suffers through the "best health care system in the world," and for every American who wants to assure quality care for themselves and those they love.

Details

Rowman & Littlefield Publishers

Pages: 284 • Trim: 6¼ x 9⅛

978-1-4422-1462-0 • Hardback • April 2012 • $27.00 • (£19.99) - Currently out of stock. Copies will arrive soon.

978-0-8108-9584-3 • Paperback • December 2017 • $29.00 • (£19.99)

978-1-4422-1464-4 • eBook • April 2012 • $27.50 • (£19.99)

Subjects: Health & Fitness / Health Care Issues, Medical / Caregiving, Political Science / Public Policy / General, Medical / Health Care Delivery, Medical / Health Policy, Business & Economics / Insurance / Health

Author

Jeffrey M. Lobosky, M.D., is Associate Clinical Professor in the Department of Neurological Surgery at the University of California San Francisco and is Co-Director of the Neurotrauma Intensive Care Unit at Enloe Medical Center in Chico, California. He has served on the Board of Directors for the Joint Section on Trauma and Critical Care for the American Association of Neurological Surgeons and the Congress of Neurological Surgeons. He was also appointed one of organized neurosurgery's representatives to the American College of Surgeon's Committee on Trauma which advises national policy makers on health care issues. Dr. Lobosky has served as Chairman of the Board of the "Think First" National Injury Prevention Foundation and has received both national and international acclaim for his work on injury prevention. He is the author of numerous research articles in respected journals as well as several book chapters addressing the health care crisis in America. He is the recipient of numerous awards for his contributions to the field of trauma prevention and is an invited lecturer throughout the United States and abroad.

Table of Contents

Prologue

1: Great, Another Book on America’s Health Care System.
Don’t You Have Better Things to Do, Doctor . . . Like Play Golf?
2: Health Care in America: The Best That Money Can Buy . . . Oh, Really?
3: Insuring America’s Health: A Lesson in “Mis”Managed Care
4: The U.S. Pharmaceutical Industry: Providing the Right Pill for Whatever Ails You and the Wrong Pill for Whatever Doesn’t
5: The Politics of American Medicine: Show Me the Money and I’ll Show You the Problem
6: America’s Hospitals: Havens of Mercy or Dens of Thieves?
7: America’s Physicians: Oops, Sorry, I Mean Health Care “Providers”
8: Physician Reimbursement: You Can’t Always Get What You Want, but if You Try Sometimes You Might Find You Don’t Even Get What You Need
9: Pretty in Pink: The Influence of Women on America’s Medical “Man”power
10: The Medical Malpractice Crisis: How Many Lawyers Does It Take to Chase an Ambulance?
11: Crisis in America’s Emergency Rooms: Take Two Aspirin and Call 911 in the Morning
12: The Great American Patient: You Didn’t Really Think I Would Let You Off That Easily, Did You?
13: Solutions to the American Health Care Crisis: My Wife Has Always Accused Me of Being a “Know-It-All,” So Here’s My Chance to Prove It

Epilogue
Acknowledgments
Notes
Index
About the Author

Reviews

Lobosky is not a health-care-policy expert, but rather a practicing neurosurgeon with nearly three decades of experience caring for the ill and injured. Written at least partly as an act of catharsis, his book condemns the contemporary state of the American health-care system and offers well-reasoned remedies. Lobosky bemoans the breakdown of the traditional doctor-patient relationship. He finds collective fault with the current system; everyone is responsible for its failure. In his view, there are “no absolute villains.” Money is the source of much of the trouble. In 2010, more than $2.5 trillion were expended on the country’s health care. The chief cause of bankruptcy in the U.S. is catastrophic medical debt. This doctor finds the emphasis on profit in medical care problematic. The system needs an infusion of compassionate care. In his timely book, Lobosky makes a sound diagnosis: “market-based, profit-driven medicine has for the most part proven to be a colossal failure on many fronts.” The cure remains frustratingly elusive.

— Booklist

This book offers a cogent, uncompromised look at what our health care system has wrought.
Dr. Lobosky is not your typical East L.A. name, but hale from there he does, and he provides the Grand Canyon view of health care in America through his career as a doctor on the front lines of health care delivery.
Moreover, he does not spare any punches with his contemporaries, either, making the book both a good read as well as objective—not always the case in the health care furor these days....

As the stench from the election year permeates our air, keep this book on hand for some straight talk on the real machinations of the U.S. health care system when one of those pundits comes a-calling.
— New York Journal of Books

Neurosurgeon Lobosky's history/manifesto aims to explain and expose healthcare in America by tracing insurance from 2100 B.C.E to contemporary Washington health politics.
— Publishers Weekly

Wise, lucid, and readable, Dr. Lobosky's book explores the many ways that the U.S. health care system is dysfunctional. Wise words from a wise man.

— Richard D. Lamm, Governor of Colorado, 1975–1987, Co-Director of the Institute for Public Policy Studies, University of Denver

Dr. Jeffrey Lobosky unabashedly diagnoses American healthcare as broken. 'It's Enough To Make You Sick' is provocative, challenging and timely. You may not agree with everything you read, but you will never think about health care the same way again. We all have a stake in making things better and Dr. Lobosky shows us the way.
— Nancy L. Snyderman, M.D., F.A.C.S., NBC News Chief Medical Editor, associate professor Head and Neck Surgery, University of Pennsylvania, M.D., F.A.C.S., NBC News Chief Medical Editor, associate professor Head and Neck Surgery, University of Pennsylvania

Too many Americans either do not have health insurance or have inadequate coverage. Where, how, and when they receive health care distorts their quality of care and the health care system. Americans call the US health delivery system the best in the world; the country spends far more money on health care than any other society, and yet US health status statistics are largely mediocre. Neurological surgeon Lobosky (Univ. of California, San Francisco) describes a system dominated by special interests (insurance and pharmaceutical companies, trial lawyers, the medical profession, for-profit hospitals, and many others), who frequently place profits over patients. Politicians often have a limited understanding of the complex health care system; in response to pressures from these special interests and well-meaning constituents, they have created a system that is too costly, too complex, and fragmented with less than the desired health care outcomes. The current system is not only undermining the doctor-patient relationship but creating patients who are not sure that physicians act in their best interests. Lobosky provides valuable insight into the current health care dilemma and, in the context of the current political environment, suggests meaningful reforms to put patient needs at the center of care. Summing Up: Recommended. General readers; upper-division undergraduates and above.

— Choice Reviews

Features

• Debunks the myth that America is home to the “best health care system in the world”

• Describes the evolution of health insurance and its place in our system today

• Explains how “managed care” wrested control of patients from their doctors and placed it in the hands of corporate executives

• Takes various entities to task for the current failure of our system, including Big Pharma, legislators, insurance companies, doctors, and patients