#68 - Marty Makary, M.D.: The US healthcare system—why it’s broken, steps to fix it, and how to protect yourself

In this episode, Marty Makary, Johns Hopkins surgeon and NYT bestselling author, discusses his ambitious attempt to fix the broken U.S. healthcare system through educating the public, changing the lexicon, encouraging radical transparency in pricing, and more. We go in detail into the main drivers of inflated health care costs, the money games being played making it hard to understand, and the unfortunate system structure that has resulted in one in five Americans finding themselves in medical debt collections which can ruin the lives of people and families seeking basic medical care. Marty also shares some very practical advice and tips if you find yourself a victim of predatory pricing and stuck with an outrageous medical bill. In the end, despite the current state of the system, Marty discusses the many exciting trends gaining traction in healthcare and why he is very optimistic and hopeful about the future.

We discuss:

• The science of delivering healthcare, how we need to do better as a system, and why no single person or entity fully to blame [10:15];
• The stories that prompted Marty to write his first book (Unaccountable) [19:15];
• The Surgery Checklist [26:15];
• The problem is with the system (not any one person or entity) and the misaligned interests of all the parties involved [28:15];
• Patients crave honesty and transparency, and the story of Peter’s back surgery gone wrong [33:00];
• Today’s med students and young doctors have less tolerance for predatory pricing and healthcare industry BS [44:30];
• Funny stories about John Cameron (legendary surgeon at Johns Hopkins) [48:00];
• How doctors are trained to internalize traumatic experiences which can result in a misunderstood form of “burnout” [57:40];
• The beat down of med students with traditional medical education and some exciting innovations to medical education [1:07:00];
• Exciting trends in healthcare and an optimistic view of the future [1:11:30];
• The Price We Pay (Marty’s new book), an attempt to illuminate the blackbox that is the US healthcare system [1:21:00];
• Why it’s not always in the best interest of the insurance company to negotiate the best price [1:28:30];
• Who is actually paying for medical costs, and Marty’s frustration with the healthcare lexicon [1:32:00];
• Pros and cons of a single payer system [1:37:00];
• How to fight outrageous medical bills and predatory pricing (and make a dent in the wasteful healthcare spending for the country) [1:49:30];
• Disrupting the healthcare industry with private healthcare facilities with market demanded transparency [2:05:45];
• The people hurt the worst by the current US healthcare system, the sad breast cancer statistic, and the importance of knowing that medical bills are negotiable [2:09:30];
• The healthcare industry bubble [2:14:00];
• Increased costs from unnecessary tests and procedures [2:16:30];
• Malpractice concerns due to the litigious culture in America: What influence does it have on unnecessary testing, healthcare costs,  and overall quality of treatment  [2:22:00];
• Drug pricing, price gouging, middle-men money games, kickbacks, and other drivers of healthcare costs [2:27:45];
• How can we possibly fix the healthcare system? [2:34:30];
• Helpful resources [2:46:15]; and
• More.

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