The health care system has changed. Munster native Dr. Michael Young has been there to see it happen.
He remembers the days when you had time to talk to patients — to actually inquire about their lives, not just their medical conditions. He was around when insurance companies didn't dictate which patients you saw. When medicine was more a calling than a business.
Those days are gone, he says. He'd like to help bring them back.
Young, who now lives in Chicago, recently released a book, "The Illness of Medicine: Experiences of Clinical Practice," that details exactly how health care got sick — and how he believes it can be treated.
"I want people to become aware, hopefully start a dialogue, a discussion on where it's going," he said.
Young, 59, was born in Gary and raised in Munster. He came from three generations of physicians. He said he wanted to be a doctor "the day I was born."
He graduated from Munster High School before attending Indiana University and, for medical school, Rush University. (He now lives in Chicago, but his mother, brother and sister still live in Munster.)
He started practicing urology three decades ago. Slowly, things began to change.
Insurance companies, drug makers and hospitals started having more influence, he said. They continually got bigger — and thus got more say.
He got so fed up he stopped practicing altogether in 2017. He believed he could make medicine better from the outside. He teaches at the University of Illinois at Chicago, where he helps develop new surgical and medical devices. He also started writing.
He says the quality of health care has been diminished by what he characterizes as the corporatization of medicine.
Primary care doctors have a quota of patients they have to see every day, he said, so the appointments last only minutes. He compared it to an "assembly line."
Hospitals dictate what products doctors can use based on what companies the facilities contract with, he said.
Medical offices spend much of their time on coding to get reimbursed, he said.
"Physicians have less control over their domain," he said.
It comes down to costs.
"The cost of health care in the United States is double any other country," Young said. "We have the best technology — but the least efficiency in using it."
He said that despite spending more on health care than every other country, the United States ranks around 30th in the world in life expectancy.
America — which he said is "overtested, overdiagnosed, overtreated" — does 10 billion blood tests, 100 million CT scans and MRIs, and 15 million nuclear scans a year, he noted.
"I have yet to see an ad on TV for preventive medicine," he said. Because suggesting that someone exercise, diet and limit alcohol intake doesn't bring in profit.
"I can sell a disease. I can't sell prevention," he said.
But there are solutions.
Young said health care entities must be more transparent with their prices.
"If you want to buy a car, you go online and find the price of a car," he said. "I would challenge you to call any hospital and say, 'I need a knee replacement, what's the cost?' They won't have an answer."
That's because the price depends on which insurance company you have.
He also says the pharmaceutical industry should be regulated, so medications are more affordable.
He advocates for a single-payer health care system, like those that exist in other industrialized countries. He points to Medicare and the U.S. Department of Veterans Affairs as one-payer systems that are more cost-efficient, because they can negotiate better contracts with pharmaceutical companies and medical suppliers.
"The current status of health care delivery can't continue," he said. "It is too inefficient, too fragmented, and we don't get the quality we should."
In the future, Young wants to do more public speaking and advocacy on this issue — he didn't rule out running for office.
Until then, he's writing his second book. It's a murder mystery. Involving a doctor.