<p>In this episode, Marty Makary, Johns Hopkins surgeon and NYT bestselling author, discusses his ambitious attempt to fix the broken U.S. healthcare system through educating the public, changing the lexicon, encouraging radical transparency in pricing, and more. We go in detail into the main drivers of inflated health care costs, the money games being played making it hard to understand, and the unfortunate system structure that has resulted in one in five Americans finding themselves in medical debt collections which can ruin the lives of people and families seeking basic medical care. Marty also shares some very practical advice and tips if you find yourself a victim of predatory pricing and stuck with an outrageous medical bill. In the end, despite the current state of the system, Marty discusses the many exciting trends gaining traction in healthcare and why he is very optimistic and hopeful about the future.</p> <p><span style="color: #201f1e;">We discuss:</span><span style="color: #333333;"><br /> <br /></span></p> <ul> <li><span style="color: #201f1e;">The science of delivering healthcare, how we need to do better as a system, and why no single person or entity fully to blame [10:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The stories that prompted Marty to write his first book (Unaccountable) [19:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The Surgery Checklist [26:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The problem is with the system (not any one person or entity) and the misaligned interests of all the parties involved [28:15];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Patients crave honesty and transparency, and the story of Peter's back surgery gone wrong [33:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Today's med students and young doctors have less tolerance for predatory pricing and healthcare industry BS [44:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Funny stories about John Cameron (legendary surgeon at Johns Hopkins) [48:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">How doctors are trained to internalize traumatic experiences which can result in a misunderstood form of "burnout" [57:40];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The beat down of med students with traditional medical education and some exciting innovations to medical education [1:07:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Exciting trends in healthcare and an optimistic view of the future [1:11:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The Price We Pay (Marty's new book), an attempt to illuminate the blackbox that is the US healthcare system [1:21:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Why it's not always in the best interest of the insurance company to negotiate the best price [1:28:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Who is actually paying for medical costs, and Marty's frustration with the healthcare lexicon [1:32:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Pros and cons of a single payer system [1:37:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">How to fight outrageous medical bills and predatory pricing (and make a dent in the wasteful healthcare spending for the country) [1:49:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Disrupting the healthcare industry with private healthcare facilities with market demanded transparency [2:05:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The people hurt the worst by the current US healthcare system, the sad breast cancer statistic, and the importance of knowing that medical bills are negotiable [2:09:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">The healthcare industry bubble [2:14:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Increased costs from unnecessary tests and procedures [2:16:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Malpractice concerns due to the litigious culture in America: What influence does it have on unnecessary testing, healthcare costs, and overall quality of treatment [2:22:00];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Drug pricing, price gouging, middle-men money games, kickbacks, and other drivers of healthcare costs [2:27:45];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">How can we possibly fix the healthcare system? [2:34:30];</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">Helpful resources [2:46:15]; and</span><span style="color: #333333;"><br /></span></li> <li><span style="color: #201f1e;">More.</span><span style="color: #333333;"><br /></span></li> </ul> <p>Learn more: <a href="https://peterattiamd.com/">https://peterattiamd.com/</a><br /> <br /> Show notes page for this episode:<a href="https://peterattiamd.com/martymakary/"><span style="color: #333333;">https://peterattiamd.com/martymakary/</span></a><br /> <br /> Subscribe to receive exclusive subscriber-only content: <a href="https://peterattiamd.com/subscribe/">https://peterattiamd.com/subscribe/</a><br /> <br /> Sign up to receive Peter's email newsletter: <a href="https://peterattiamd.com/newsletter/">https://peterattiamd.com/newsletter/</a><br /> <br /> Connect with Peter on <a href="http://Facebook.com/PeterAttiaMD"><u>Faceboo</u></a><u>k</u> | <a href="http://Twitter.com/PeterAttiaMD"><u>Twitter</u></a> | <a href="http://Instagram.com/PeterAttiaMD"><u>Instagram</u></a>.<br /> <br /></p>
Actionable Insights
1. Challenge Predatory Medical Bills
If concerned about predatory billing, sign ‘did not read’ on any consent forms presented at a vulnerable time. If collectors pursue an egregious bill, demand to see the legal contract obligating you to pay, as such a contract often doesn’t exist.
2. Negotiate Medical Bills
Always remember that medical bills are negotiable. When you receive a bill, you can often negotiate the amount down with the provider or collections agency.
3. Use GoodRx for Prescription Prices
Before filling a prescription, use GoodRx to compare cash prices at local pharmacies. The cash price is often lower than your insurance copay or what your employer is charged, potentially saving you money.
4. Seek Second Opinions & Ask Questions
When facing medical decisions, get a second opinion and ask specific questions to ensure you understand your care options and minimize potential medical errors.
5. Recognize True Healthcare Payer
Understand that ‘your insurance company paid’ or ‘your employer paid’ for healthcare actually means you paid through your premiums, wages, or benefits. This shift in perspective highlights personal financial impact.
6. Report Predatory Billing to Authorities
If you receive an egregious medical bill, contact your state’s attorney and local news networks to report the predatory billing practices.
7. Engage Local Hospital Boards
As a community member, get involved with your local hospital, especially if it’s a non-profit. Ask board members about their policies for uninsured patients, bill management, average markups, and whether they pursue aggressive collections against low-income individuals.
8. Adopt Honest Healthcare Lexicon
Use patient-centered language in healthcare discussions, referring to ‘prices’ instead of ‘costs’ and acknowledging that ‘you’ ultimately pay for care, not just insurance or employers. Identify egregious bills as ‘predatory billing practices’ to foster clearer communication and accountability.
9. Hire Independent Healthcare Brokers
Businesses should seek out independent healthcare brokers who do not receive kickbacks from insurance companies or PBMs. This can lead to significant cost savings on health insurance and pharmacy benefit plans.
10. Adopt Globally Capitated Primary Care
Businesses should consider partnering with globally capitated primary care clinics like Iora, ChenMed, or Oak Street. This model assumes long-term risk for beneficiaries, aligning incentives for better patient outcomes and reduced costs.
If you are a medical professional and something goes wrong, reach out to the patient immediately and disclose the mistake. This fosters honesty and can prevent lawsuits, as patients are often forgiving when there is transparency.
12. Process Traumatic Medical Experiences
Medical professionals should actively address and talk about traumatic experiences to cope with them, rather than internalizing emotions and becoming desensitized, which can negatively impact bedside skills and personal life.
13. Advocate for Transparent Pricing
Physicians should channel their advocacy efforts towards championing fair, honest, and transparent pricing in healthcare to restore public trust and address the cost crisis.
14. Find Transparent Healthcare Brokers
Businesses seeking independent and ethical healthcare brokers can consult Health Rosetta (healthrosetta.com), which vets brokers committed to transparency and a code of conduct, helping avoid kickbacks and secure better deals.
For more information on healthcare reform, predatory billing, and patient advocacy, visit restoringmedicine.org and martymd.com for resources and guidance.
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