by Marty Makary
Chapter 14: Pharmacy Hieroglyphics
1. M. Thompson, “Why a Patient Paid a $285 Copay for a $40 Drug,” PBS, August 19, 2018.
2. Pharmacy Benefit Managers, “Health Affairs Health Policy Brief,” September 14, 2017, doi:10.1377/hpb20171409.000178.
3. K. Van Nuys et al., “Frequency and Magnitude of Co-payments Exceeding Prescription Drug Costs,” Journal of the American Medical Association 319, no. 10 (2018): 1045–47.
4. S. Lieberman et al., “A Billion Here, a Billion There: Selectively Disclosing Actual Generic Drug Prices Would Save Real Money,” Health Affairs, August 8, 2018.
5. Ohio’s Medicaid Managed Care Pharmacy Services, Auditor of State Report, August 16, 2018.
6. Ohio Pharmacists Association, “Ohio Auditor Releases Stunning Medicaid PBM Audit Report,” https://www.ohiopharmacists.org/aws/OPA/pt/sd/news_article/184063/_PARENT/layout_interior_details/false.
7. M. Allen, “In Montana, a Tough Negotiator Proved Employers Don’t Have to Pay So Much for Health Care,” ProPublica, October 2, 2018.
8. S. Lupkin, “Patients Overpay for Prescriptions 23% of the Time, USC Analysis Shows,” Los Angeles Times, March 14, 2018.
9. L. L. Gill, “Shop Around for Lower Drug Prices.” ConsumerReports.org, April 5, 2018.
Chapter 15: 4K Screens
1. W. E. Bruhn et al., “Group Purchasing Organizations, Healthcare Costs, and Drug Shortages,” Journal of the American Medical Association, November 2018.
2. Healthcare Supply Chain Association, “A Primer on Group Purchasing Organizations,” https://c.ymcdn.com/sites/www.supplychainassociation.org/resource/resmgr/research/gpo_primer.pdf, accessed July 2018.
3. Premier Inc. Reports Fiscal 2017 Fourth-Quarter and Full-Year Results, August 21, 2017, 45.
4. M. Blake, “Dirty Medicine,” Washington Monthly, July/August 2010.
5. U.S. Food and Drug Administration, “Statement from Douglas Throckmorton, M.D., Deputy Center Director for Regulatory Programs in FDA’s Center for Drug Evaluation and Research, on the Agency’s Response to Ongoing Drug Shortages for Critical Products,” published June 2018, accessed July 23, 2018.
6. U.S. Government Accountability Office. “Drug Shortages: Certain Factors Are Strongly Associated with This Persistent Public Health Challenge,” https://www.gao.gov/assets/680/678281.pdf, published July 2016, accessed July 19, 2018.
7. Committee on Oversight and Government Reform (2012), “FDA’s Contribution to the Drug Shortage Crisis,” https://oversight.house.gov/wp-content/uploads/2012/06/6-15-2012-Report-FDAs-Contribution-to-the-Drug-Shortage-Crisis.pdf, accessed July 22, 2018.
8. R. E. Litan et al., “An Empirical Analysis of Aftermarket Transactions by Hospitals,” Journal of Contemporary Health Law and Policy 28, no. 1 (2011): 34.
9. R. E. Litan and H. J. Singer, “Broken Compensation Structures and Healthcare Costs,” Harvard Business Review, October 6, 2010.
10. U.S. Government Accountability Office, “Group Purchasing Organizations: Research on Their Pricing Impact on Health Care Providers,” published January 29, 2010, publicly released March 1, 2010, https://www.gao.gov/new.items/d10323r.pdf.
11. D. Liljenquist et al., “Addressing Generic-Drug Market Failures—the Case for Establishing a Nonprofit Manufacturer,” New England Journal of Medicine 78, no. 20 (2018): 1857–59, doi:10.1056/nejmp1800861.
12. L. A. Johnson, “FDA to More Aggressively Tackle Disruptive Drug Shortages,” Associated Press, July 12, 2018.
13. M. Hiltzik, “Supply Middlemen May Leave Hospitals Ailing,” Los Angeles Times, April 14, 2005, accessed August 2018.
Chapter 16: Diagnosis: Overwellnessed
1. G. Claxton et al., “Employer Health Benefits 2017 Annual Survey,” Kaiser Family Foundation, 2017.
2. Stern Speakers, “Dr. Peter Attia: Readdressing Dietary Guidelines,” YouTube video, 1:19:04. Posted on Jan 28, 2015, https://www.youtube.com/watch?v=nhzV-J1h0do.
3. D. Mozaffarian et al., “The 2015 US Dietary Guidelines: Lifting the Ban on Total Dietary Fat,” Journal of the American Medical Association 313, no. 24 (2015): 2421–22.
4. C. E. Kearns et al., “Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents,” JAMA Internal Medicine 176, no. 11 (2016): 1680–85.
5. S. Zhang “Big Pharma Would Like Your DNA: 23andMe’s $300 Million Deal with GlaxoSmithKline Is Just the Tip of the Iceberg,” Atlantic, July 27, 2018.
6. K. Baicker et al., “Workplace Wellness Programs Can Generate Savings,” Health Affairs 29, no. 2 (2010).
7. D. S. Hilzenrath, “Misleading Claims about Safeway Wellness Incentive Shape Health Care Bill,” Washington Post, January 17, 2010.
8. M. A. Makary et al., “Operating Room Briefings: Working on the Same Page,” Joint Commission Journal on Quality and Patient Safety 32, no. 6 (2006): 351–55.
9. M. A. Makary et al., “Operating Room Teamwork among Physicians and Nurses: Teamwork in the Eye of the Beholder,” Journal of the American College of Surgeons 202, no. 5 (2006): 746–52.
10. M. A. Makary et al., “Operating Room Briefings and Wrong-site Surgery,” Journal of the American College of Surgeons 204, no. 2 (2007): 236–43.
11. WHO Guidelines for Safe Surgery 2009: Safe Surgery Saves Lives, http://apps.who.int/iris/bitstream/handle/10665/44185/9789241598552_eng.pdf?sequence=1.
12. D. Lerner et al., “A Systematic Review of the Evidence Concerning the Economic Impact of Employee-focused Health Promotion and Wellness Programs,” Journal of Occupational and Environmental Medicine 55, no. 2 (2013): 209–22.
13. A. McIntyre et al., “The Dubious Empirical and Legal Foundations of Wellness Programs,” Health Matrix 27, no. 1 (2017).
14. A. E. Carroll, “Workplace Wellness Programs Don’t Work Well. Why Some Studies Show Otherwise,” New York Times, August 6, 2018.
15. Z. Song, and K. Baicker, “Effect of a Workplace Wellness Program on Employee Health and Economic Outcomes: A Randomized Clinical Trial,” Journal of the American Medical Association 321, no. 15 (2019): 1491–1501.
16. www.choosingwisely.org.
17. www.vezahealth.com.
18. www.validationinstitute.com/.
Chapter 18: What We Can Do
1. N. Grauer, Leading the Way: A History of Johns Hopkins Medicine (Baltimore: Johns Hopkins University Press, 2012).
2. N. Grauer, The Special Field: A History of Neurosurgery at Johns Hopkins (Baltimore: Johns Hopkins University Press, 2015).
3. S. Fried, Rush: Revolution, Madness, and the Visionary Doctor Who Became a Founding Father (New York: Crown, 2018).
4. www.choosingwisely.org.
5. www.improvingwisely.org.
6. www.hvpaa.org.
Index
The letter f following a page number denotes a figure.
addiction, opioid, here, here
Affordable Care Act, here, here, here
air ambulance costs
balance billing practices, here
broker fees, here
fair pricing, here
historically, here
inflation of, here
insurance for, here, here, here, here
price gouging, here, here
pricing transparency, here
responsibility for, here
air ambulance industry
competition in the, here, here
conflicts of interest, here
debt collection practices, here
growth in, here, here
informed patient practices, here
investigations, here
price transparency, here
recommendations, here
air ambulance industry, disrupting the, here
air ambulance services
alternatives to, here
excess of, here
necessary, here, here
quality, here
in rural America, here
safety, here
unnecessary, here
ambulances, ground, here
Americans
rural, air ambulance services for, here
savings statistics, here
anesthesia costs, here
ankle-brachial index test, here
appendicitis/appendectomies, here, here
appropriateness measures and guidelines. see also Improving Wisely appropriateness measures
belly button hernia repair, here
breast surgery, here
chemotherapy for early breast cancer, here
demand for, here
dental care, here
elective back surgery, here
end of life care, here
engaging physicians in, here
hemorrhoid banding, here
implications, here
metrics, defining, here
Mohs surgery, here
opioid prescriptions, here
spinal surgery, here
automobile sales, here, here
back surgery, here, here
balance billing practices, here
ballooning, here, here, here
bankruptcy, medical, here. see also hardship, medical
belly button hernia repair, here
billing practices, balance, here
billing practices, predatory
Carlsbad Medical Center, here
markups, here, here, here, here
resources for addressing, here
bills, itemized
availability of, here
forms and delays when requesting, here
biometric screening, here
blood transfusions, here
breast cancer, appropriateness measures, here
breast surgery, here
broker fees, air ambulances, here
cancer
breast, here
cost of care, here
Korea’s thyroid cancer epidemic, here
thyroid cancer, here
cancer surgery, here
Carlsbad, NM
courthouse, here
described, here
judicial system, here
Rent-a-Center employees, here
Carlsbad Medical Center
billing practices, predatory, here
garnishment practices, here, here, here, here, here, here
lawsuits, here, here
medical procedures, unnecessary, here
charitable care, here, here, here
chemotherapy prior to cancer death, here
childbirth
cost of, here
C-sections, here, here
children
dental care for, here
hernia repair, here
cholesterol, high, here
Choosing Wisely, here, here, here, here
church health fairs, here, here, here
claudication, here, here, here
coal miners, here
colon polyp removal in screening colonoscopies, here
community clinics, here, here
Community Health Systems
financial aid policy, here
garnishment practices, here, here
lawsuits/civil lawsuits, here
medical tests, unnecessary, here
patient stories, here
predatory billing practices, here
community partnerships, here
court fees, here
credit scores, ruined, here, here, here, here, here
C-sections, here, here
CT scans, here
customer satisfaction, here
data collection, here, here. see also appropriateness measures and guidelines
debt collection practices, here, here, here, here, here, here
dental care, here, here
doctors
compassionate, here
educating, here
maverick phenomenon, here
outlier. see appropriateness measures and guidelines
quality, markers of, here
duty of care, here, here
emergency room bills, markups, here
EMTALA law, here
end of life care, here
ethics
duty to inform physician outliers, here, here
of price negotiation, here
financial aid policies, here, here
flight attendants, here
fog-of-war business model, here
France, here
free market health care, here
garnishment practices
amount allowed by law, here
Carlsbad Medical Center, here, here, here, here, here, here
Columbus Community Hospital, here
Community Health Systems, here, here
doctor’s knowledge of, here
faith-based hospitals, here
nonprofit hospitals, here
Virginia, here
genetic testing, here, here
group purchasing organizations (GPOs), here
hardship, medical. see also garnishment practices; lawsuits, hospital
air ambulance costs, here
credit scores, ruined, here, here, here, here, here
middlemen in, here
practices contributing to, here
predatory billing practices and, here, here, here
statistics, here, here
unnecessary medical procedures and, here
health care. see also medical care
changing, here
choosing, here
employer-based, here
freedom of choice, here
reforming, here
shopping for, here, here
vocabulary, here
health care costs. see also air ambulance costs; hardship, medical; medical care costs
for anesthesia, here
appropriateness measures and, here
billing practices, predatory, here, here, here
drivers of, here
fair pricing, here
garnishment practices, here, here, here, here, here, here
hospital caused infection, cost to patient, here
insurance premiums, here, here
lawsuits, here, here
lifestyle modification to reduce, here
medical procedures, unnecessary, here, here
negotiating, here
out-of-network, here, here, here, here
patient responsibility for, here
patient stories, here, here, here
price negotiations, here
surprise bills, here
variation in, here
health fairs, here, here
health insurance
air ambulance services, here, here, here, here
deductibles, burden of, here
medication, here
premiums, here, here
private, payments from, here
self-funded, here
health insurance broker industry, reforming the, here
health insurance brokers
credentialing, here
flat fee, here
ice cream metaphor, here
kickbacks, here, here
numbers of, here
subprime mortgage crisis similarities, here
health insurance carriers
discount negotiations, here, here, here
discounts, secret, here, here, here
kickbacks to brokers, here, here
heartburn, here
heart bypass surgery, cost of, here
hemorrhoid
banding, here
hernia repair, pediatric, here
Hopkins, Johns, here, here
hospital bureaucracy, here
hospitals
buying supplies for, here
contractual obligation to pay, here
duty of care, here
errors caused by, cost of, here, here
fair-priced, here
faith-based, here
financial aid policies, here, here
historically, here
markup and discount practices, here, here, here
price gouging, here, here, here
responsibility for costs of treatment, here
surprise bills, here
hospitals, nonprofit
lawsuits filed, here, here
price gouging, here
tax-exempt status, here
Improving Wisely appropriateness measures
background, here
breast surgery, here
dental care, here
elective back surgery, here
end of life care, here
function, here
hemorrhoid banding, here
Mohs surgery, here
pediatric surgeries, here
income, physician, here, here, here
inequality, here, here
innovations, here
interest rates, here
IRS, here, here
joint replacement surgery, here
judicial system, here, here. see also lawsuits, hospital
kickbacks
GPO, here
health insurance brokers, here, here
legislating, here
safe harbor exemption, here, here
lawsuits, hospital
Carlsbad Medical Center, here, here
Columbus Community Hospital, here
Community Health Systems, here
doctor’s knowledge of, here, here
faith-based hospitals, here
nonprofit hospitals, here, here
Virginia, here
leg pain, here
lifestyle modification, here
mail order medications, here
Mary Washington Hospital, here
Medicaid
air ambulance reimbursement rates, here, here, here
drug spending, here
hospital profitability and, here
non-qualifers, price gouging of, here, here
medical care. see also health care
patient’s right to refuse, here
relationship-based, here
shoppability, here, here, here, here
medical care costs. see also air ambulance costs; health care costs
blanket charges, here
emergency room bills, here
laws allowing, here
pricing, randomness in, here, here
shoppability in, here
surprise bills, here