Elisabeth Rosenthal

A colonoscopy had a strong impact on the direction of Elisabeth Rosenthal’s life. It wasn’t the prep, procedure or clinical findings that had the effect. It was the price.

Rosenthal, who entered the professional world as an emergency physician and transitioned into working as a medical journalist, began writing articles about the rising costs of healthcare, and she ultimately decided the facts and the need for far-reaching patient action merited a book.

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back (Penguin Press; $28 hardcover) has become the focus of a speaking tour around the country. She will speak for the Metro Detroit Book and Author Society Luncheon Monday, May 15, at Burton Manor Banquet and Conference Center in Livonia.

Rosenthal will be joined by four other authors introducing new books: Chris Hayes (A Colony in a Nation), Stephen Hunter (G-Man), Megan Miranda (The Perfect Stranger) and Dan Egan (The Death and Life of the Great Lakes).

“My book begins by laying out for every patient how our health system was hijacked by financial interests,” explains Rosenthal, a longtime writer for the New York Times and now editor-in-chief of Kaiser Health News (no connection to Kaiser Permanente or the Kaiser Health System). She hopes that people will come to understand they are not helpless in the face of our confusing and expensive healthcare system.

The second part of the book is filled with news-you-can-use tips to help navigate individual healthcare and questions we should be asking our public servants in Washington.

Rosenthal recalls how reading her insurance information after that colonoscopy made such a dramatic impression. She had just returned from 10 years as a correspondent in other countries, where she experienced solid healthcare firsthand along with tenable pricing.

Her colonoscopy charges originally were $10,000 but had been bargained down to $9,000 by the insurance company. Rosenthal believed most people would be glad to learn of such a deduction. She also believes the $9,000 eventually will be passed along through widespread higher deductibles and premiums.

With research, she saw the need for patients to partner with personal physicians to find lower costs on tests and procedures, negotiate with providers for lower costs and complain to legislators about high costs. Rosenthal shows you how to do it in the book.

“We shouldn’t be uncomfortable doing this,” Rosenthal says. “Doctors need to help us at this tough time in American medicine.”

Career Shift

Rosenthal started writing for the New York Times after four years of practicing medicine. Her decision came about because of three circumstances. First, her specialty was internal medicine, and rules were changing to require more emergency training. Next, her second child was born, and that made overnight shifts difficult.

Third, emergency work had made her conscious of needs that weren’t and aren’t being met — so it was a big draw to be able to write about it rather than confront it one patient at a time.

After making the career change, she was covering Hillary Clinton’s work to legislate healthcare reforms in the 1990s. That assignment turned into the series “Paying Till It Hurts.”

“My assumption had been I would go back to emergency medicine after the Clinton legislation passed,” Rosenthal says. “But it didn’t pass, and the problems weren’t solved. So here I am, 25 years later, writing about similar issues — but worse.

“Then, it was a subset of some people not being served well, but now it’s all of us,” she said. “We all deserve better and can work toward better if we start asking questions of our providers and representatives in our states and in Congress.”

For example, did your representative get donations from the pharmaceutical industry? How does that impact why Medicare can’t negotiate drug prices? Is your state insurance commissioner making sure insurance directories are accurate so it’s not hard to find a doctor in your network?

Rosenthal suggests finding out who these people are and whether they are working on our behalf.

Rosenthal learned a lot about individuals’ problems and solutions through responses to her series of articles and audience remarks after her speaking presentations.

“We would do a story about the high price of colonoscopy, for instance, and we would ask people if there were other procedures where they’ve seen costs out of line with the care they got,” Rosenthal explains. “People shared their stories, and over time, that snowballed. I started a Facebook group on patient costs, and people contributed more stories.

“Many of them shared very personal stories because they were so upset with what was happening to healthcare. They were stressed by the confusion and financial hits they took. Even the relatively small bills —and in our system, that can be hundreds of dollars — are pretty large.

“An American living in Turkey decided not to come back to the U.S. to have her second child because it would cost so much. Others shared helpful solutions about how they were able to bargain a better price on a hospital stay. It’s sad that we have to do that, but we should all know we can protest bills.”

Rosenthal attributes her commitment to these issues to her late dad and uncle as role models. The men, twins who both practiced medicine, are described as exhibiting a sense of caring, a sense of mission and a sense of duty linked to Jewish teachings.

“One of the most meaningful things that happened to me in the wake of this book was a call from a cousin who also became a physician,” Rosenthal says. “My cousin commented that our fathers would be really proud of us both because they both trained at Bellevue and had this sense of public service, which I think is connected to religious values.”

Suzanne Chessler Contributing Writer

The Metro Detroit Book and Author Society Luncheon begins at 11 a.m. (with the opening of the book sale room) Monday, May 15, at the Burton Manor Banquet and Conference Center, 27777 Schoolcraft, Livonia. After lunch and talks, authors will sign books. $40.
(586) 685-5750.