Does anyone really know how our healthcare system works? There is so much discussion on the issues about our healthcare system and how it can be fixed that it is overwhelming. Generally, articles and books are written in a language or style that makes it difficult to understand with assumptions and inside information and terminology that someone outside of the industry cannot comprehend.

However, author and doctor, Marty Makary “fixes” these issues in his easy-to-read and understand book “The Price We Pay: What Broke American Health Care – And How To Fix It.” In his book, Dr. Makary provides a review of our current healthcare system using real-life examples and then provides proven, workable solutions.

Most of the ills of our current healthcare system can be summed up in just three words: necessity, transparency, and accountability.


Dr. Makary outlined the issue of over-testing, over-medication, and over-treatment and the usual profit-driven, rather than results-driven, model of our healthcare system.

As an example, Dr. Makary noted his own previous misunderstanding, based on the advice of the drug manufacturers, that opioids were a safe, effective, and non-addictive pain treatment over other less dangerous medications, such as over-the-counter pain relievers.

Bottom Line:  Patients should conduct their due diligence on their medical care and recommendations from their providers to include, if needed, a qualified second opinion for any elective procedure or medications.


The current system of healthcare system suffers from so much purposeful obfuscation, hidden financial cost and gain, and so many layers of bureaucracy that even the most educated patient has difficulty understanding the process and making the best decision for their healthcare, both medically and financially.

However, if our healthcare delivery system was treated like any other customer product or service, where the patient (that is, the customer) could “shop” or compare the exact same product and service prior to purchase, it could eliminate most of the issues in our healthcare system.  There are probably no other products or services that a consumer buys without knowing the full, exact cost until after-the-fact.  Imagine eating an apple and then having the cashier demand $100.00 for it?

Bottom Line: all services and fees should be published, easily available, and understandable.


Dr. Makary demonstrates, through the power of peer benchmarking, the positive effect of peer pressure on healthcare providers.  Through Dr. Makary’s help, the providers who participated, understood how they performed relative to other providers in the same specialty.  And using simple bell-chart analyses, Dr. Makary and his team were able to work with the providers who were outliers to help them improve their performance, and therefore reduce cost.

It was noted that the providers themselves were not fully aware of the financial costs and burdens of their care to their patients.

Bottom Line:  with few exceptions, all services and fees should be the same cost to the patient, regardless of where those services are rendered.