Catastrophic Care: How American Health Care Killed My Father

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It’s not often I read a book that is so compelling and thought-provoking I dog-ear nearly every other page and have to keep a pen in my hand constantly so I can be ready to underline at will. One might think that a nonfiction tome about health care and “insurance” would be dry reading, but in the case of Catastrophic Care, this treatise on where we’ve gone wrong and where we can go from here is riveting.

Author David Goldhill wrote an Atlantic piece about health care after his father died from hospital-borne infections while being treated for pneumonia. I happened to hear about the article and that Goldhill would be turning it into a book, and when the book finally made it into print, I snatched it up immediately. I have not been disappointed. Catastrophic Care is a clear and compelling explanation about our system of health care and how it’s become so bloated, convoluted, inefficient, costly and even dangerous.

I had already read some books and articles in the past that had helped me get a good idea of how health insurance has evolved and how that has caused health care prices to go up to ridiculous levels. Of course, no one knows what prices “really are” for any doctor visit, procedure or test because they vary depending on the health care plan, the facility or provider, and the patient himself. And, as Goldhill writes, every single one of us in the United States has a long list of complaints about our health insurance or our care, as well as at least one horror story of improper care. He asks, “Why do we tolerate the carnage inflicted by our hospitals?”

First, health “insurance” is not truly insurance. It is a payment plan. Second, we as the patients are not the true customers of health care providers; the payment intermediaries or “Surrogates,” as Goldhill calls them (our insurance companies), are. Since we aren’t the real customers, we can’t and don’t demand better service from our providers. Goldhill writes that health care has become different from other business industries not because it is necessarily completely different inherently but because we have “insisted on treating it as different. Everything about health care … exists on a separate island from the mainland of every other service or product in our economy. … Though these products of convoluted laws and rules manage to thrive on the Island of Health Care, they would not survive on the Mainland, where all other industries are forced to compete for their customers.”

Goldhill walks us through the evolution of this system and then actually outlines a plan for how we could “pull it back to the Mainland” and treat it like a business while we become the real customers once again. Unfortunately, even though his ideas are not just well considered, sound and simple, but nearly genius, it will likely take a huge crisis in health care in this country for us to overhaul our broken system, whether we use his ideas or not.

I could write pages and pages about this excellent book. But I simply say to everyone, Read this. Share it with friends and family. Think about how you can use these ideas to suggest changes in our system to our political leaders. It will take a groundswell of ordinary citizens’ opinion and involvement for us to get from this mess we’re in now to a truly workable system that treats us well as patients and consumers and that doesn’t confuse and frustrate us at every turn, let alone actually harm our health. Read this excellent book.

Rated: Moderate. There are two quotes in this book that use profanity: one in the very last chapter before the afterward and appendices, and one at the beginning of chapter 4, making a grand total of two uses of strong language and four uses of moderate language. Aside from those two quotes (one from a movie and one from comedian Chris Rock), the book is completely clean and free of any objectionable material.

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