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Catastrophic Care: How American Health Care Killed My Father--and How We Can Fix It Hardcover – January 8, 2013

4.3 out of 5 stars 95 customer reviews

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Editorial Reviews

From Booklist

Dysfunctional and undisciplined. That is Goldhill’s assessment of the current U.S. health-care system. President and CEO of the Game Show Network, Goldhill believes the trouble stems from “a culture lacking customer accountability: high prices, excess, errors, underinvestment in information technology, lack of follow-up.” Spurred by the death of his father from a hospital-acquired infection, Goldhill has devoted considerable time and thought to repairing health care. His book sprouted from a 2009 article he penned for the Atlantic. Encounters with the health-care system usually involve gargantuan intermediaries—Medicare, Medicaid, and private insurance companies, entities Goldhill cites for inefficiency. They also generate increased demand for services. His alternative to the status quo combines national health insurance (for everyone but not everything) with a market-based system that gets rid of intermediaries and allows individuals to deal directly with providers. Individual health accounts, catastrophic insurance with a high deductible, and health loans are key components. The health-care system is gashed. Goldhill thinks it’s time to rip off the colossal Band-Aid and apply a different kind of balm. --Tony Miksanek


"David Goldhill has written a devastating and utterly original analysis of what has gone wrong with the American health care system. Read it, and take a deep breath. He will convince you that our ‘solutions’ are not solving our problems. They are making our problems worse."
—Malcolm Gladwell

"David Goldhill is a genius observer of a broken system in need of fresh ideas. His testimony and common-sense ideas are devastatingly important in light of out-of-control medical prices. A must-read for doctors, policy-makers and patients alike. Catastrophic Care is a defining book of our era, and a roadmap for fixing our country's leading debt driver. You will never see medical care the same way."
 —Marty Makary, MD, best-selling author of Unaccountable: What Hospitals Won't Tell You and How Transparency Can Revolutionize Healthcare
"For those who are troubled by both the failures of our healthcare system and the misdirected diagnoses and prescriptions offered by pundits, policy experts, and politicians from across the political spectrum, David Goldhill offers a brilliant and much needed antidote. By calling out with remarkable clarity the numerous, but now almost invisible incentives and regulations that drive the dysfunction of our current system, Catastrophic Care provides an illuminating framework for understanding the crisis, and then a path to the kinds of reforms that will surely be necessary."
 —Jeffrey S. Flier, Dean of the Faculty, Harvard Medical School

"[A] fascinating and infuriating expose of the American health care system . . . Goldhill persuasively argues that a consumer-driven system – which will require greater vigilance and commitment on the part of citizens in actively managing their health – is the first step toward sustainability and lower individual and government costs. . . . Goldhill's reasoned, logical alternative to the current system goes beyond political finger-pointing, and while his take is sobering, it’s one that offers sound solutions." 
—Publishers Weekly (starred review)

"[Catastrophic Care] is powerful—edge-of-the-seat riveting—because it is not, in any sense, a policy book. Rather, this is a story about saving ourselves . . . It steps outside of the established political debate and lexicon—one of the rare books addressing a major national policy issue that is able to do so in language not already debased by the problem itself . . . Alas, healthcare civilians can't actually read most books about healthcare (and if you can, then you are part of the problem). But you can read this one."
—Michael Wolff, The Guardian 
"Highly readable presentation of one businessman’s solution, likely to provoke discussion if not agreement." 
Kirkus Reviews 
“Rarely has the irrationality of the [healthcare] system been so convincingly demonstrated, including the opaque and highly inflated prices of medical care.”
—Arnold Relman, The New York Review of Books

"Thought provoking . . . A for-profit business executive who actually states that better than adequate health care should be available to all people in the country . . . As an industry outsiderneither a clinician, policymaker, or someone who works for the healthcare industryMr. Goldhill observes and explains the issues in an understandable manner for the layperson."
New York Journal of Books

"The best popular health care book . . . a crystal clear account of what has gone wrong and how to fix it."
—Tyler Cowen, Holbert L. Harris Professor of Economics, George Mason University

"[A] comprehensive, thought-provoking, empirical, and well-written book."
—Matthew Continetti, The Weekly Standard

—Wayne Holliday, Decatur Daily

“Goldhill’s perspective is invaluable to the health-care discussion, elevating his personal tragedy into an impressive body of research.  Written with both pain and passion, this book provides an informative and relatable treatise.”
—Elizabeth J. Eastwood, Library Journal

"Innovative . . . Goldhill presents a convincing argument in many ways, and this book already has challenged policymakers to examine his proposals.” 
—William P. Moran, Charleston (SC)Post and Courier

“David Goldhill isn’t your typical policy expert. He is the chief executive officer of GSN. That’s right, the Game Show Network. What does he know about health care? Quite a bit, it turns out.”
—Chelsea Conaboy, Boston Globe, White Coat Notes

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Product Details

  • Hardcover: 384 pages
  • Publisher: Knopf; 1 edition (January 8, 2013)
  • Language: English
  • ISBN-10: 0307961540
  • ISBN-13: 978-0307961549
  • Product Dimensions: 5.2 x 1.3 x 7.8 inches
  • Shipping Weight: 12 ounces (View shipping rates and policies)
  • Average Customer Review: 4.3 out of 5 stars  See all reviews (95 customer reviews)
  • Amazon Best Sellers Rank: #696,554 in Books (See Top 100 in Books)

Customer Reviews

Top Customer Reviews

By Ilya Valkovsky on November 11, 2013
Format: Kindle Edition Verified Purchase
Written for a general (but thinking) audience, this book could really turn around all public discourse on health care and become a seminal work on the subject.

The divisive health care debate of recent years is centered over WHO should shoulder astronomic medical costs. The issue of taming the exorbitant prices and costs is relegated to the side issue of waste and abuse. David Goldhill takes a new and different approach. He puts aside the standard assumption that health care is somehow exempt from the normal rules of economic activity. He focuses on WHY the costs became so exorbitant in the first place. Goldhill shows persuasively that the costs are the result of the very design of our current medical system, and the only way to bring the costs down to earth is to REPLACE entirely the current economic arrangements of our medicine - both the private insurance system and Medicare/Medicaid.

That's a book of new ideas. These ideas are breakthrough innovative, brilliant, deeply thought through; analysis superb. As with all things new and complex, it requires an effort to understand. If you have any background or interest in economics, even the economics of everyday life, give it more consideration.
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Format: Hardcover Verified Purchase
I was a practicing cardiologist in the US for over 30 years. I, as most other practicing cardiologist, was trained and fully believed the prevailing methods of diagnosis and treatment were not only correct but absoluely necessary. Several decades of experience taught me this is not close to being accurate. The majority of medical tests, and much of the treatment,is not only unnecessary, but harmful and/or dangerous. The goal of the majority of providers is to increase total "sales" by ordering many procedures and or drugs that are not needed. Much of this is done from ignorance and is not necessarily indicative of a purely capitalistic motive.

David Goldhill is one of the few authors that have experienced this travesty and is educated and intelligent enough to understand the consequences of this nationwide epidemic and the needless, wasteful, and dangerous care. His ability to sort through all of the "noise" prevalent in the governmental and media diatribe and isolate the real problem as full insurance for everyone is unique. This system is doomed for failure. There will never be enough resources to fund medical care as long as the consumer is not the payer. They will always demand more and the providers are happy to accomodate them.

I have left the US and am presently living in Beijing, China, attempting to establish purely preventive heartcare clinics. This is more general education regarding diet, smoking, sedentary lifestyle, and alcohol abuse. than traditional western medicine. Less income, but certainly more satisfying.
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Format: Hardcover Verified Purchase
Who could be against health care for all?! The problem is that the system we have and pushed further in ACA, decouples decisions from individuals and instead gives them to surrogates with strong political pressures to approve any and all procedures. And many other consequences that lead to an ineffective, even harmful health care system and an incredibly expensive one with lots of opportunity for abuse.

This book is an excellent primer and should be required reading for all those in the legislature who make health care decisions. I have no idea if the prescription offered in the book as an alternative is a reasonable one, but I do know it opened up my eyes to some of the devastating problems with the status quo.
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Format: Hardcover
We aren't going to solve our nation's fiscal problems without fresh thinking on health care, which consumes almost 18% of our GDP, with no end in sight to its enormous growth. This brilliant new book reframes the national conversation about health care. Currently the debate is framed around health coverage: who gets covered, how plans compete, what Medicare/Medicaid should and shouldn't pay for, etc. This framing assumes that paying for health care through a surrogate, like a health plan or Medicare, is a priori the only way of doing business in health care.

David Goldhill believes that assumption is in fact the root cause of the problems in health care. A businessman in the entertainment industry, he was blissfully unaware of some of the failings of our health care system--until he encountered them full force with his father's hospitalization and death from infection. He wondered why the healthcare system played by an entirely different set of rules than he did in the business world.He studied the problem for a few years, and this book is the result.

He makes a strong case that surrogates drive costs up and quality down, and our health care system is on a crash-course to devastate our economy. He says that we as Americans cherish the myth that we don't really pay for our own health care, our health plan or Medicare does. That myth, says Goldhill, is the core of the problem in our health care system, and the seed of the solution.

Goldhill's perspective and his proposed solutions are unorthodox and will likely generate some controversy. But given the serious problems in our health care system, this incisive book is critical and a must-read for policymakers on both sides of the aisle.
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