Brad Spellberg - Broken, Bankrupt, and Dying: How to Solve the Great American Healthcare Rip-off

I am pleased to introduce Broken, Bankrupt, and Dying , by Dr. Brad Spellberg. I have known Brad for many years as an esteemed colleague and friend and have been constantly impressed by his presence as the Chief Medical Officer of a large academic safety - net hospital, a respected researcher, author, and erstwhile policy wonk, among other things.

When he told me hed written a new book, I was only a little surprised. After all, even the busiest doctor/administrator/lab researcher has to find something to do at 4:00 a.m. when insomnia kicks in. When he told me what the book is about, all I could say was, Sounds like what Ive been saying for the last decadeat least youve written it down!

Healthcare is complicated, and healthcare policy and economics can be very difficult to understand. The debate about healthcare in the United States rages onoften becoming a political footballengendering highly partisan arguments, but rarely truly resolving these questions. If you are looking for a solid introduction to some of the key problems we face in American healthcare, without the partisan political rhetoric, this book is an excellent start by focusing on the practical win - win possibilities, rather than ideological arguments.

There are many concepts in healthcare policy that are complicated, but at least one is fairly simpleif youre going to pay for something, you should at least get your moneys worth! This book explains in relatively simple terms why thats not true for the American healthcare system, why we should be bothered by it, and what we can do to fix it.

As Brad explains, despite the fact that many Americans insist that we have the best healthcare system in the world, it isnt true by most measures. Because of the hodgepodge system that we have let develop over time, the American healthcare system does not serve everyone, and the people that it does serve, it does so at a high cost. The thing that Americans should ultimately take offense to is not that our healthcare system costs as much as it does, but that it provides terrible value for doing so. And people die because of it. Fundamentally we have been paying Rolls - Royce prices for Kia - level luxury, and it doesnt have to be that way.

Brad then builds the case, piece by carefully constructed piece, for an optimal solution. That solution is probably somewhat different from some of the plans youve heard prominent politicians talking about. He walks us through the alternatives, including their pros and cons, and makes a strong plea for engagement. There are few individuals in the country who, when asked, will tell you that our healthcare system isnt broken. Nonetheless, we still struggle with the political willpower to make necessary changes to make our healthcare system effective and sustainable. If we want these changes to happen, we must rely on the power of the public to demand action.

We can actually make a better healthcare system, but to do so, we need all of us to understand the problems well enough to ask for the right solutions. This book will help put people on the path to that understanding.

Arun Patel, MD, JD, MBE, FAAP

Director of Patient Safety and Risk Management

Department of Health Services

Los Angeles County

Former Staff, US House Committee on Energy and Commerce