On this episode of the podcast, Terry and Bob discuss the numerous cost-drivers that inflate the price of American healthcare. They highlight how electronic health records requirements divert doctors’ attention away from patients to unproductive bureaucratic exercises. They explain how the rebate system accounts for an enormous portion of medical spending. And they argue that the healthcare system, including state Medicaid formularies, inherently discriminates against minorities. For example, patients with sickle cell disease, which more often impacts people of color, have seen their medications threatened.

Bob interviews Dr. Marty Makary, surgical oncologist at Johns Hopkins and author of the renowned book The Price We Pay, about efforts to make healthcare more affordable. Dr. Makary discusses how financial incentives encourage doctors to just manage symptoms rather than address underlying health problems and prevent them in the first place. He points out that roughly one-quarter of healthcare spending is unnecessary. Rather than diet, exercise, and meditation, the US healthcare system is too quick to encourage surgery, medications, and expensive treatments.

Dr. Makary points to a new federal rule that requires hospitals to post their prices before care. He notes that this rule could help lower costs by getting rid of the pricing status quo where list prices are inflated to generate massive rebates that enrich special interests. The rule can convert healthcare into a competitive market. Unfortunately, he points out recent reporting by the Wall Street Journal showing that hospitals are actively hiding these prices from search engines, making them hard for ordinary patients to access. He argues that we must challenge the healthcare establishment to try to fix the broken system characterized by predatory billing.

Kate Pecora speaks with cystic fibrosis advocate Kori Tolbert about moving cross-country from New York to Colorado to receive treatment. She discusses her long treatment journey which became the equivalent of a full-time job. She explains her access to a new life saving drug called trikafta and how being on the ground with her treatment team has made her care regimen more successful.

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