Jamie Dudensing

Full text of my article @Forbes: Power Belongs To Patients: In Memory Of Marshall Allen Marshall Allen, a prominent healthcare investigative journalist, author, and educator, passed away on May 19, 2024, at the age of 52. Throughout his illustrious career, he fought for one cause: empowering patients. Mr. Allen was a reporter for ProPublica from 2011 to 2021. He received the Harvard Kennedy School’s Goldsmith Prize for Investigative Reporting and was a Pulitzer Prize finalist. Since 2012, he had been teaching at the Craig Newmark Graduate School of Journalism at the City University of New York. In 2021, Mr. Allen published his magnum opus, Never Pay the First Bill, to educate patients on how to achieve the best value for their healthcare dollars. The book was a huge success, currently on Amazon’s Best Seller list in consumer guides. In this book, Mr. Allen crystallizes five simple truths: 1. Healthcare Is Paid Solely By Workers and Taxpayers. The $4.5 trillion and rising pumped into U.S. healthcare each year comes neither from employers nor the government. It comes exclusively from workers and taxpayers. Employers who manage their workers’ health benefits serve as fiduciaries spending the money deducted from workers’ take-home wages. Every dollar spent by government programs is earned by taxpayers, whether deceased, alive, or yet to be born. 2. Patients Are Powerless Because They Do Not Control Their Own Money. Money is power. Businesses want to make their customers happy, but only if customers control their own money. When patients’ money is controlled by insurance companies or government programs, power abandons patients—they don’t even get to know what the price is. Those who control the money prioritize their own interests, which are rarely aligned with patients’. 3. Healthcare Is A Money-Making Business. Businesses exist to make money. In the process, they compete to innovate and satisfy customers, benefiting society and growing the economy. However, in healthcare, where policy-induced uneven playing fields and monopolies are common, powerless patients get a bad deal—high spending with little or even negative value. 4. Workers and Taxpayers Deserve A Better Deal. Wasteful spending in healthcare is Mr. Allen’s enemy, whether it be high prices, administrative complexities, middlemen, fraud, or unnecessary treatments. He believed that the money wasted should have been retained and directed by workers and taxpayers themselves for more productive purposes. Imagine how much more we could have accomplished with that money. 5. Our Healthcare Reality Is By Design. When the government plays a bigger role in healthcare, policymakers and businesses get more intimate. Influencing policy is more effective than competition for large businesses to make money, and controlling healthcare dollars is more effective than empowering patients for policymakers to reap political gains. This business-policymaker marriage perpetuates a system that enriches both while compromising patients, workers, and taxpayers. The key to breaking this vicious cycle is, in Mr. Allen’s words, to “stand up to bullies” and “fight back.” Indeed, no matter how invincible the system may look, its patient-decentered nature will continue to fail patients and invite forces of nature like Mr. Allen to stand up and disrupt. As more patients and stakeholders benefit from patient-centered approaches, political constituencies will emerge to ignite more positive changes. Mr. Allen fought a glorious battle to reveal the truths and inspire us. He dedicated his work to “anyone who’s been pushed around by the American healthcare system.” Now, it’s up to us to remember what he fought for and march on: Power Belongs To Patients. forbes.com/sites/gebai/2024/… @JHUCarey @JohnsHopkinsSPH @BSPH_HPM