Brought to you by:



Download the guide here. Print it. Live by it.

SOME SYMPTOMS AND
CAUSES OF AMERICA'S
HEALTH CARE PROBLEM

(Other than the fact that we spent all of our money on
tanks and missiles so there's none left for you)


SYMPTOMS

WE’RE NUMBER 1!! America spent $3.6 TRILLION on health care in 2018,
20% of our GDP.
Source: Centers for Medicare & Medicaid Services and CIA World FactBook

• The average premium for family coverage has increased 22% over
the last five years and 54% over the last ten years.
Source: The Henry J. Kaiser Family Foundation

WASTE in the U.S. health care system
is $760 billion to $935 billion annually, or 25% of total medical spending,
according to a new analysis published in JAMA.
Source: Journal of American Medical Association

(SOME) UNDERLYING CAUSES

INSURANCE COMPANIES + HOSPITAL GROUPS
Companies negotiate with doctors and hospitals to set prices, and
when they can’t agree, the insurance companies just
pass the cost on to the consumer because why not!?!

MEDICINE FOR PROFIT - PRIVATE EQUITY HAS INVADED HEALTH CARE
Private equity investors have caused consolidation among health care
companies and hospital groups, decreasing competition and increasing costs.

PHARMACEUTICAL COMPANIES
Yea, they're just plain evil.
Pure, uncut, premium grade, extra-strength malicious evil.

DOCTORS
Driven by financial incentives and defensive medicine (the fear of being sued),
many doctors overtest their patients.
Low value or unnecessary care and overtreatment contribute to
$75.7 billion to $101.2 billion in waste every year.
Source: Journal of American Medical Association


BEFORE YOUR MEDICAL APPOINTMENT:
EDUCATION



Research, research, research.

Ugh, but you hate reading.

What if I told you that if you were to do just a little research, you could

potentially save hundreds or even thousands or even millions (probably not) of dollars?



Just pretend you’re about to take your car to a mechanic,

and you want to make sure you don’t get screwed.

Now imagine that the car is you and the doctor is the mechanic.

Also, your medical issue is your “undercarriage”

because it’s a double entendre and we’re a comedy show.

Odds are you aren’t smarter than a doctor, but that doesn’t mean you can’t pretend to be.

Neil Patrick Harris made a career out of it.

Use the following resources to be fully informed BEFORE you go into the doctor’s office:

Choosing Wisely
will tell you what to expect

Health Care Bluebook
will tell you what other people are paying

Your Insurance Provider (if you’re lucky enough to have it)
find out if your doctor is in network or out-of-network - a lot of doctors don’t even know themselves

The Doctor’s office
ask them about facility fees
(which is like a cover charge that some fancy offices won’t disclose)
DURING YOUR MEDICAL APPOINTMENT:
COMMUNICATION



Your relationship with your doctor

(and yes! It is a relationship,
and one that sometimes involves them “touching you”)

rests on two things: Trust & Communication.

You must communicate to your doctor all of your questions and concerns.

Trust their answers are in your best interest.


Don’t hold back

Tell your doctor everything related to your illness or injury - no detail is too small.

Sometimes doctors will overtest because they’re trying to rule out something that you may not have revealed.

So yes, you should probably tell them the exact reason why your nose is so unusually stuffy.

They know what you’ve been up to and it’s terrible for you.



Ask the right questions

1. Is this test necessary or are you just covering your bases?

2. Is this test / procedure you’re suggesting going to change my treatment?

3. What is the value-add of what you’re suggesting?

4. Are there cheaper options?

5. Do you have a conflict of interest? Are you getting paid by commission?
Do you own the place you’re saying I should go to?

It ain’t over ‘til it’s over

1. Before you leave the office, request an itemized bill just like when you put your card down at a restaurant,
take a photo of the bill and then ask for money from EVERYONE on Venmo.

2. Challenge anything you didn't order.
Let them know you HATE surprises.

AFTER YOUR MEDICAL APPOINTMENT:
NEGOTIATION



Haggle, haggle, haggle.

Don’t feel like you’re powerless.

Remember, they already gave you the medicine.

They can’t take it back.


Call both your insurance company (if you’re lucky enough to have insurance)
and your provider directly and take notes on your call like you’re a 3rd year med student,
and there’s about to be a pop quiz on your own anatomy.


Write EVERYTHING down!
This is your chance to be your own court stenographer!

Write down who you talk to,
when you talked to them,
the number you called,
what you asked for,
and what their response was.


If you think a bill is too high,
challenge every item.

Challenge everything from the $7 bandage to the $3,000 “observation” charge.


Let them know that you’re
willing to work with them.

Suggest a payment plan, a discount for paying early, washing dishes, etc.


If something is outrageous
GO TO THE PRESS.
If there’s one thing hospitals and doctors hate more than not getting paid,
it’s bad publicity. SHAME WORKS, PEOPLE.


IF YOU GET A SURPRISE MEDICAL BILL -
one that’s outrageously high or one
that’s completely unexpected -
follow the above steps.
If that doesn’t work - talk to PATIENT ADVOCATES
and bring your notes. (you took notes right?)


GO TO THE PRESS.
Shout the outrageousness from the rooftops.
Ride through the streets like you’re Paul Revere warning that the “Medical Bills are coming!”
And Remember, Health Care Starts
With Taking Care Of Your Health.
BE WELL,
GET WELL.

SHOUT OUTS

While we'd love to take the credit for all of this, we can't.
This site and the associated piece could not have been possible without:

Dr. Sandeep Jauhar
Cardiologist, NY Times Best Selling Author

Dr. Elisabeth Rosenthal
Physician & Editor-in-Chief of Kaiser Health News

Sarah Kliff
Journalist covering Investigations & health policy for NY Times

Dr. Atul Gawande
Surgeon, Writer, Professor
(We didn’t talk to him, but his writing helped inspire this piece)


ADDITIONAL READING

IF YOU WANT TO STAY MAD: BILL OF THE MONTH

TIME TO FIGHT HOSPITAL MONOPOLIZATION

THE WORLD’S CHEAPEST HOSPITAL HAS TO GET EVEN CHEAPER

PRIVATE EQUITY MAKES YOU SICKER


DISCLAIMER - THE NOT SO FINE PRINT
Every health care thing, legally, has to tell you that it won’t solve your problems.
This pamphlet certainly won’t. But it’s a start. But also, none of these statements have been approved by the FDA.
No dentists recommend this because we didn’t ask them.
They’re dentists. What do they know? All teeth and no bite, those dentists.

Also, if this is an emergency, stop reading and dial 9-1-1.
Where are your priorities if you’re reading during an emergency?
Are you still reading? STOP AND CALL 9-1-1. Unless your emergency is that you just discovered you can read.
In which case - read away you literate son of a gun.