Like virtually all Americans, you have probably sensed that something is terribly wrong with the US health care system. Feeling helpless, you may have reluctantly agreed with the academics, public policy wonks, and politicians who promised that a massive round of legislation from Washington would set the country back on track.
Yet the Patient Protection and Affordable Care Act—also known as the ACA or simply “ObamaCare”—is only the most recent of a string of government initiatives, going back at least to the Great Depression, aimed at improving the delivery of health care to Americans. This history forces us to ask: is the ACA actually working? Or is it, instead, exacerbating the very problems it was supposed to solve, setting us up for another crisis down the road? In the meantime, while the politicians and pundits bicker, what can Americans do to keep their families healthy?
The book you are holding answers just these questions. It contains the real history of what went wrong with US health care and insurance, and explains why so many people thought massive new legislation was necessary. Once you realize exactly how and why American health care had fallen into such a hole on the eve of the Affordable Care Act, you will understand that the new legislation is only making things worse. Indeed, we will use the government’s own estimates to show how all workers—not just “the rich”—are going to pay hundreds of billions more in taxes to make the legislation “pay for itself.” Furthermore, you the reader will be shocked to see how many millions of people the government itself predicts will be paying fines rather than obtaining the “universal” and “affordable” health insurance that is now supposedly a federal guarantee. With relentless arguments, data, and real-world examples from an ER doctor, we will convince you that the delivery of US health care will only become more inefficient, frustrating, and bureaucratic over the coming years.
In this book, we argue that each round of increased government intervention within the health care and health insurance sectors has further hobbled the ability of the market economy to provide quality service at affordable prices. Yes, health care is a crucial component of a person’s lifestyle, and that might make Americans hesitant to rely on “the free market” to deliver it. But food, clothing, and shelter are even more fundamental staples of life, and most Americans would agree that having the government act as a “single payer” for all of their purchases at the grocery store and The Gap would be an absolute disaster. And if a giant new government agency—perhaps called “Housicare”—were given the power to tax all paychecks in order to pay for all home purchases and apartment rentals (according to an official schedule of prices corresponding to family size and job location), the disruption in the market would be mind-boggling. By severing the direct connection between buyer and seller, consumers’ satisfaction with their homes and apartments would suffer while prices would soar. After a few years of such a nutty system, the housing market would be just as screwed up as … well, as the health care and health insurance markets currently are.
Make no mistake: though we have strong views on the political drama in Washington and its disastrous fallout for average Americans, this book is not partisan. Indeed, our historical journey will show you that the problems with US health care are a bipartisan affair, the fault of legislation signed into law by both Democrats and Republicans, including the conservative icon Ronald Reagan. Seen in the proper historical perspective, “ObamaCare” is simply an extension of the trends that have been in motion for decades.
Fortunately, there is a way out for you and your family. The primary purpose of this book is to educate you, the reader, so that you’re better equipped to take control of your own health. We are strong advocates of the “primal” lifestyle of diet and exercise (as popularized most notably by Mark Sisson) as a baseline for promoting the default status of wellness in your life. The best way to avoid the problems of a faulty health care system is to stay healthy.
Yet sickness and sometimes even hospitalization are unavoidable parts of life, and this book offers a complete introductory guide for these topics as well. We provide a framework for choosing your doctor, picking an insurance plan, surviving a hospital stay, reducing (or eliminating) your medications, evaluating the merits of medical screening procedures such as mammograms, and getting accurate information on elective procedures. Our goal here is not to tell you “the answers,” but instead to give you a framework—or a blueprint—for making the right decisions for you and your family.
An added virtue of our recommendations is that they can be implemented immediately, without the need to convince politicians (or other voters) to change their own views or actions. We do offer some policy solutions for the broader US health care system, but these are given mostly for the sake of logical completeness, and to avoid charges that we are mere complainers. The overall delivery of US health care and health insurance could be improved very quickly with those solutions, but the great news is that you have the power to take charge of your own health regardless of what others do.
We have certainly promised you a lot in this book, so let’s take a moment to explain why we are qualified to deliver on those promises. The problems with US health care are obviously medical in nature, but they also involve economics—especially because one of the biggest problems is how expensive care (and insurance) has become. That is why the two authors of the book you are currently holding decided to join forces: one of us (McGuff) is an MD with years of experience in the trenches of the emergency room, while the other (Murphy) holds a PhD in economics and has experience in academia, the financial sector, and DC-based policy analysis.
To put it simply, in this book the doctor co-author will give his firsthand account of what has been happening on the ground, while the economist co-author will explain how the policies adopted by government and insurance providers are causing these absurd—and heartbreaking—outcomes. Although we will be taking (well-deserved) swipes at some of the “experts” in our respective fields, our criticism will be of their hubris—of failing to appreciate the complexity and self-regulating properties of both the human body and the market economy. We are not here to criticize intellectualism, per se, but instead puncture the myths that the cutting-edge research has toppled.
There is so much we want to tell you from our respective fields of medicine and economics. As bad and shocking as the rumors about “ObamaCare” or hospital practices may be, we promise you: the reality is worse. Yet we understand that your time is valuable, which is why we have boiled down our report to include only what you most imperatively need to know. The Primal Prescription will first walk you through exactly what went wrong with US health care, and in so doing will turn the conventional wisdom upside down. Then, armed with the truth, you will learn what practical steps you can take to navigate the health care debacle that will—for those who aren’t prepared—only get worse before getting better.
Doug McGuff, MD
Robert P. Murphy, PhD