The ProspectiveDoctor Podcast

The (Broken) American Healthcare System with Dr. Brad Spellberg

Chase DiMarco talks with Dr. Brad Spellberg, an infectious disease specialist, Chief Medical Officer at the Los Angeles County and the University of Southern California Medical Center, and Director of Biosciences for Los Angeles County. They discuss Brad’s book Broken, Bankrupt, and Dying: How to Solve the Great American Healthcare Rip-off.

[0:42] Introducing Dr. Brad Spellberg

[3:35] Comparing American Healthcare to That in Other Countries

[8:02] The Cost of American Healthcare

[12:21] Origins of Unaffordable Health Insurance

[16:05] Solutions to the American Healthcare Problem

[20:28] How the Audience Can Inspire Better Healthcare

[22:09] Further Resources

Based on a study by the Commonwealth Fund, a nonpartisan, nonprofit organization, the US ranks 11th out of 11 peer nations for healthcare. This includes ranking the worst for outcome — how well a nation prevents deaths that are amenable to treatment such as diabetes and pneumonia. This also includes being the most expensive — regardless of whether the metric is total cost, cost per capita, or cost as a percentage of GDP. Furthermore, based on a 2019 survey by the Kaiser Family Foundation, the average cost of premium alone for a family to purchase their own health insurance is $20,000 per year.

The unjust and inhumane healthcare system was unplanned, and arose because during World War II, 1. to prevent inflation, employers were not permitted to raise salaries, but were still permitted to provide additional employee benefits like health insurance and 2. to fund military equipment, the IRS removed all income tax deductions except for the ones on insurance. For the system to change today, people must accept that the system is bad and have the will to change it. Besides this, partisanship around healthcare issues should be removed. To illustrate, Dr. Spellberg proposes a healthcare system that involves both multi-payer and single-payer options. Everyone would pay a tax, ensuring baseline healthcare under the single-payer option, but those who want private healthcare are permitted to pay extra. This reduces the polarization of the two options as associated with different parties. Single-payer, multi-payer and hybrid systems have all been shown to work in other countries, in terms of both cost and outcome.

So what can you do about this? Besides educating yourself, take the time to increase awareness amongst your neighbors and friends. Representatives at Capitol Hill will listen and advocate for their constituents. So speak up and remember to vote!

Here are further resources that you might enjoy:

2019 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Average Annual Family Premium per Enrolled Employee For Employer-Based Health Insurance

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

You can find out more about Brad via his Website or contact him via Twitter!

Sign up for a Free Coaching session with Chase DiMarco, sponsored by Prospective Doctor! You can also join the Med Student Mentor FB Group to ask questions and receive guidance related to clinical rotations and clinical knowledge!

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Chase DiMarco

Chase DiMarco is an MS, MBA-HA and MD/Ph.D-candidate. He is the founder of FreeMedEd, a free medical education resource, the host of the Medical Mnemonist 1-Minute Preceptor podcasts by MedSchoolCoach, creator of several medical education platforms, and CEO of FindARotation clinical rotations service.

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