Sick To Debt

How Smarter Markets Lead To Better Care


The United States has the most expensive healthcare system in the world. While policy makers have argued over who is at fault for this, the system has been quietly moving toward high-deductible insurance plans that require patients to pay large amounts out of pocket before insurance kicks in. The idea behind this shift is that patients will become better consumers of healthcare when forced to pay for their medical expenses.

Laying bare the perils of the current situation, Peter A. Ubel—a physician and behavioral scientist—note that even when patients have time to shop around, healthcare costs remain largely opaque, difficult to access, and hard to compare. Arguing for a middle path between a market-based and a completely free system, Ubel envision more transparent, smarter healthcare plans that tie the prices of treatments to the value they provide so that people can afford to receive the care they deserve.



“Weaving together wonderful stories and rigorous research, Peter Ubel reveals why making patients better healthcare consumers is tremendously difficult and what—besides more ’skin in the game’—is necessary to make them better at shopping for medical care”

EZEKIEL J. EMANUEL, author of Prescription for the Future: The Twelve Transformational Practices of Highly Effective Medical Organizations

“The best book on healthcare reform in a generation. Peter Ubel shows how to help patients, which is to say all of us, above all by enabling people to make good decisions. He points the way towards saving a ton of money—and a lot of lives.”

CASS R. SUNSTEIN, coauthor of Nudge: Improving Decisions about Health, Wealth, and Happiness

“Peter Ubel is one of the most important voices in improving healthcare decisions. IN this highly readable book, he balances descriptive case examples with clear exposition of the concept, and his voice is strong and euphonious”

ALAN SCHWARTZ, University of Illinois at Chicago

Sick to Debt exposes the problems that arise when policy makers assume healthcare markets work like typical consumer markets. Weaving together exploration of behavioral science with observations of actual doctor-patient interaction, Ubel’s engaging book challenges us to rethink American healthcare.”

GEORGE LOEWENSTEIN, Carnegie Mellon University

“Medical care leaves many people drowning in debt. Peter Ubel shows why it is naïve to think that patients are empowered by paying more for care and how to design smarter markets for medicine. Few topics are more important or handled by more of an expert:

DAVID CUTLER, Harvard University