Paying Until It Hurts

Does the Cost of Healthcare Make Us More Healthy?


Paying Until It Hurts


Post Written by Dominique Pandy


When Transform presenter Elisabeth Rosenthal, M.D. began writing Paying Till It Hurts for the New York Times, health care consumers readily sacrificed their privacy and offered up their own experiences so their stories could be told. In a fitting opening for Mayo Clinic’s 2014 Transform Symposium, she highlighted current concerns with the American medical system that were covered in her series.

These concerns include drug prices, procedure prices, and hospital costs in the current United States medical system. Rosenthal’s 11-part series examined where the money in the medical system is going, and sought to answer the question of why healthcare costs are so much more expensive in the United States when compared to other countries.

While originally trained in internal medicine, Rosenthal decided to leave her medical practice and working for the New York Times in the early 90s. She described during her presentation how experiencing other healthcare systems throughout her travels gave her insight on how healthcare can be approached differently in the United States.

In one part of her series, Rosenthal focused on a reader named Renee Martin, a pregnant woman whose insurance policy did not cover maternity care. Martin was facing $4,000-45,000 in hospital costs. Martin had to negotiate all of the costs of each procedure with the hospitals, forcing her to make economic decisions rather than decisions about what was best for her child. Her emotionally compelling story shows us how much room we have for innovation in remodeling the healthcare system.

What happened in Martin’s case is no longer legal, but while the laws regarding insurance policies and maternity have changed there are still improvements to be made. In another section of her series, Elisabeth Rosenthal describes how colonoscopies are more expensive in the United States than in other countries.

She reports that the average U.S. price for a colonoscopy is $1,185 compared to Switzerland’s $655. Additionally, there is a wide variation of prices for colonoscopies depending on geographical location even within the United States, despite the fact that the procedures in each state remain the same. For example, in New York an average colonoscopy costs about $9,000 whereas in Baltimore a colonoscopy is only $1,908.

Rosenthal points out that not only are the prices of hospital care different in the United States, but the hospitals people are staying in look different. She notes how many hospitals in the United States resemble nice hotels, and mentions an online quiz she developed called “Is this a Hospital or Hotel”. The quiz is meant to highlight these similarities and how nicer, newer hospitals are driving up prices for patients while the same level of care is being provided.

After interviews with patients, doctors, economists, and workers in the healthcare industry, Rosenthal found that the current system is not working for many consumers. Her inauguration of the symposium served to outline each of these problems so other speakers could discuss the solutions. She accomplished this by providing a narrative of the specific stories of patients who have struggled to manage costs and treatments in the current system.

While the state of healthcare is constantly changing, Rosenthal believes that there is always room for innovation and improvement.


Dominique Pandy

Dominique is currently a student at the University of Minnesota Rochester, and an Intern Writer for the Center for Innovation.




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