The best books on how being an expat taught me to loathe America’s healthcare system, and what could be done about it

I found Fixing the Primary Care Crisis as I was researching the root cause of America’s healthcare problems. Dr. Schimpff shares keen, frontline insights into how we arrived at a crisis point. He dials in on time with the patient as a critical factor, and how primary care was devastated over many decades by government and insurance intrusion. That he became a medical mentor is another fortunate outcome from discovering his book. He helped refine my thinking and incorporated it into my book. Fixing the Primary Care Crisis is the first book I recommend for understanding what we have now and solutions for fixing it. I was very proud to have him as my first Winning Healthcare Food Fights podcast guest.

In my ongoing research into America’s dysfunctional healthcare system, Dr. Ken Fisher was a name I kept hearing. “Read his book,” said the MDs I trust. The roots of our current mess stretch back over one hundred years. Just after blood-letting was a thing. I didn’t know Otto Von Bismarck offered a nationalized healthcare plan for Germany. Though he failed, Prime Minister Lloyd George introduced the concept to England, and the NHS was born. Ken lays out the dominoes and how they fell into today’s American system. I learned how unleashing Health Savings Accounts enables a better system than the current employer-centered mess. I was thrilled Ken agreed to be a Winning Healthcare Food Fights podcast guest. 

Ever hear of MLR or Medical Loss Ratio? I had, but it didn’t click why it was a cruel joke on American healthcare consumers until I read Marshall’s book. His give a kid a bowl of ice cream analogy is so spot on that I asked for and received his permission to quote it in my book. My dad used to say that a sure sign of genius is making a complex subject understandable to an eighth grader. Marshall’s a genius. His insights stem from over 15 years of investigative reporting on the healthcare industry are critical to combatting a downright evil billing system. Whenever a friend mentions they’ve been in the hospital, or will be, I tell them to read this book. 

Dr. Makary begins with an almost unreal story of a French citizen who had the unfortunate luck of having a heart attack in the US. I won’t give it away, but used car dealers come out smelling like roses, and I did that for a while, back in my youth. Such a lesson. Americans sorely need perspective on what great care is and how to pay for it. Dr. Makary does a fantastic job outlining two little-known middlemen sucking money out of American wallets. Pharmacy Benefit Managers, and Group Purchasing Organizations. Both use tactics that would make Tony Soprano smile.

What I love about this book, and why I recommend it, is while spotlighting problems, he offers solutions, and spotlights people making a difference.

To say moving to Panama was life-changing is an understatement. Only as an expat would I have met my medical mentor, a former White House physician. His boss was Dr. Mariano, and he recommended her book to give more of the backstory on caring for the world’s most demanding patient. Before Dr. Connie, White House care was almost informal. After President Clinton appointed her, she launched a massive care uplift to the world’s finest executive health program. So many facets of the White House Medical Unit’s procedures and thinking made even more sense when Dr. Robert Darling taught me about the thinking behind President Clinton’s care. Between these two physicians, I learned the correct answer to: How do you know you have outstanding care? (Hint: It’s not insurance.)