Elisabeth Rosenthal is a physician and journalist who is currently working as the editor-in-chief of Kaiser Health News. She graduated from Harvard Medical School and completed residency and worked as an Emergency Physician before she began working for the New York Times as a reporter. In 2017, she published a book titled, “An American Sickness: How Healthcare Became Big Business and How You Can Take it Back”, which looks at the American healthcare system and how financial incentives have impacted it. We hope you enjoy this episode where we talk about healthcare costs, physician payment models, strategic billing and more.  

Questions we asked: 

• What led you to make the switch from being a physician to being a journalist? 
• What do you mean by “health insurance as the original sin” in healthcare?
• What are your thoughts on alternative models such as Direct Primary Care or Concierge Medicine? 
• Do salary based physician payment models improve overtreatment and overbilling? 
• Could whole genome sequencing further unnecessary medical care and treatment? 
• What are other countries doing to better align healthcare cost and effectiveness? 
• What can the next generation of physicians do to cure this American Sickness?
• What books would you suggest to medical leaders? 

Quotes & Ideas: 

• Paying Till it Hurts column by Dr. Rosenthal
• Insurance separates the consumer from the true cost of medicine which allows for business to increase pricing.  
• “When you receive a ER bill for $17,000 and you’re out $3,400 for a COVID screen... that’s not skin in the game, that’s like having a kidney in the game.” 
• Patient’s can’t shop around for healthcare prices if they don’t know the prices. 
• “Why does it cost that much? Because it’s legal and people can.” 
• “Salary based physician payment often becomes salary plus incentives for revenue generation.” 
• “The goal of the physician and nursing workforce is to deliver good care to patients… The goal of the business side of healthcare is often to generate revenue.” 
• Kaiser Health News Bill of the Month 
• Bad medicine is often good business. 
• “People say pharma’s bad or PBM’s are bad, but It’s the way the system interacts with itself that is the problem.”
• “If physicians don’t bring in patients, these hospitals are nothing.” 

Book Suggestions: 

• An American Sickness by Elisabeth Rosenthal 
• The Price We Pay by Marty Makary