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Solving Healthcare's Cost Crisis

Marty Makary

Marty Makary, MD, MPH, FACS


The nation’s healthcare system is on life support with questionable surprise billing tactics, physicians performing unnecessary procedures, complex pricing structures, and bureaucracy and administrative waste threatening to pull the plug.

“It sometimes takes the whole system falling apart and shattering into pieces to make real change happen,” says Marty Makary, MD, MPH, a healthcare policy expert and surgeon at Johns Hopkins University in Baltimore, Md. “We’re at that point now.”

Dr. Makary spent 2 years visiting 22 American cities to talk with physicians, nurses, facility administrators, business leaders and insurers to identify the true drivers of rising healthcare costs and explore ways to reign in the alarmingly high expense of treating patients. He detailed what he discovered in his new book The Price We Pay: What Broke American Health Care — and How to Fix It. At OR Excellence, during what’s sure to be one of the conference’s most compelling presentations, he’ll share his personal insights about the nation’s cost crisis.

  • Increased competition. Some of the most exciting innovations in cost-effective care are occurring in outpatient ORs, according to Dr. Makary. “I’m encouraged to see areas of health care becoming more competitive,” he says. “Same-day joint replacements are a perfect example. They’re being done in highly competitive markets where facilities are being rewarded for providing value-based care.”

Dr. Makary believes surgical innovations will help ensure technologies that contribute to high-quality, affordable care will come to market more quickly than ever before.

  • Frontline feedback. The big thinkers in health care are approaching the nurses and surgeons who work in the trenches, the ones with the hands-on experience and real-world insights needed to come up with the ideas that gradually evolve into game-changing evolutions. “How can we redesign patient care? How can we increase competition?” says Dr. Makary. “Providers are being asked the key questions that will ultimately help drive down the costs of care.”
  • Remember what matters. Some health systems and insurers are using predatory billing practices that are saddling patients with mountains of debt and ruining their lives, according to Dr. Makary. “It would disgust any healthcare provider,” he adds. “It violates our oath and mission.”
The Price We Pay cover

Moral outrage at unfair billing practices has inspired numerous physicians, nurses and facilities to spearhead the movement toward honest billing and price transparency.

“Health care is a business, but we’ve seen in competitive markets that businesses run with high ethical standards can thrive and innovate,” says Dr. Makary. “There will always be plenty of patients to care for and plenty of opportunities to be paid fairly — and paid well.”

  • Decentralized care. For decades, healthcare leaders have promised that consolidation — large health systems creating accountable care organizations by employing physicians and buying up local facilities — would lead to incredible innovation and more cost-effective care.

“But we haven’t been told the whole story,” says Dr. Makary. “In reality, innovation occurs more often in small centers, which are more agile and can develop new technologies and ideas faster.”

He calls for replacing traditional models of market domination with relationship-based models in which surgical facilities serve communities with affordable, patient-centered care and engage in new innovations that meet the expanding clinical needs of their patients.

Dr. Makary is excited to discuss big-picture trends in surgical care and share the great optimism he has about the ways disruptive healthcare innovators are redesigning the traditional healthcare model to make it more efficient, cost-effective, patient-centered and affordable. “We all have to understand that it’s possible to run an efficient and profitable surgical business,” he says, “while staying true to the moral principles that drew us to the profession in the first place.” OSM

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