Here is Keith Toussaint's Book Review: The Price We Pay: What Broke American Health Care,and How to Fix It. This was the presentation made to the https://www.meetup.com/Chicago-Technology-For-Value-Based-Healthcare-Meetup on October 29, 2019.

1. The Price We Pay
What Broke American Healthcare — And How to
Fix It
By Marty Makary, MD

2. Summary
Johns Hopkins Surgeon Dr. Marty Makary (also author of Unaccountable: What
Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care, 2012)
Demonstrates how medical care is secretive and predatory
Skyrocketing costs due to “money games” of medicine
Book came out of traveling across the country identifying overtesting,
overdiagnosing, and overtreatment as big drivers

3. Anatomy of
the book
Part I: Gold Rush
Part II: Improving Wisely
Part III: Redesigning Health Care

4. Gold Rush
• Predatory Health Fairs
• Beware the church-based ‘health fairs’
• Pricing Games
• Welcome to the bazaar (truly bizarre
• Carlsbad (hospital lawsuit epicenter)
• One Hospital: Tens of Thousands of lawsuits
• Two Americas (some sue, some don’t)
• In Virginia: the majority of hospitals do not
sue
• 37% of hospitals did sue
• over 20,000 lawsuits in one year

5. Improving
Wisely
• Addressing over-treatment
• By survey: estimated 22% of prescription
medications, 25% of medical tests, and 11%
of procedures are unnecessary.
• Transparency
• Mohs surgery for skin cancer
• Surgery Center of Oklahoma: up-front
pricing for surgery
• Opioid alert
• Medical best practices lagging

6. Redesigning
Health Care
• Starting from Scratch
• Iora, Oak Street, Chen Med, et. al.
• Know Your Prices
• Healthcarebluebook.com
• Value-based health insurance
• HealthRosettal.org
• Redesigning Pharmacy Benefits
• Eliminating kickbacks
• Group Purchasing Organizations
• Workplace wellness?

7. Rays of Hope
• Choosing Wisely
• https://www.choosingwisely.org
• Improving Wisely
• https://www.improvingwisely.org
• High Value Practice Academic Alliance
• https://www.hopkinsmedicine.org/armstrong_institute
/improvement_projects/high-value-health-care/high-
value-practice-alliance/
• American Sickness
• https://www.penguinrandomhouse.com/books/318776
/an-american-sickness-by-elisabeth-rosenthal/
• Kaiser Health News Bill of the Month
• https://khn.org/news/tag/bill-of-the-month/
• Mistreated
• https://medium.com/@connect_cx/book-summary-
mistreated-118a5b5bb909