Today’s Health Populi is devoted to Steven Brill and his colleagues at TIME magazine whose special report, Bitter Pill: Why Medical Bills Are Killing Us, is required reading for every health citizen in the United States.
Among many lightbulb moments for readers, key findings from the piece are:
- Local hospitals are beloved charities to people who live in their market – Brill calls these institutions “Non-Profit Profitmakers). They’re the single most politically powerful player in most Congressional districts
- The poor and less affluent more often pay the high chargemaster (“retail list”) price for health products and services vs. the wealthy
- Defensive medicine is driving over-use of expensive, only marginally better, technologies (see my blog post yesterday on Overtreatment)
- Conflicts of interest between doctors and industry – medical device suppliers and Big Pharma — drive preferential use of products and technologies that are often not appropriate
- Mark-ups for disposable products and over-the-counter drugs are astronomical: at MD Anderson Cancer Center, a patient identified a charge on their hospital bill of $7 for an “alcohol prep pad.” A box of 200 of these can be purchased online for $1.91
- Clinician-owned labs can drive over-use as a revenue center
- Prescription drug prices are 50% greater in the U.S. than overseas…
What to do? Brill suggests many tactics, from changing Rx patent laws and cap profits of labs owned by health providers, to reforming the malpractice system (to stem overuse of unnecessary services) and “outlaw the chargemaster” — that is, to show transparent costs based on ‘real’ costs.
Health Populi’s Hot Points: The content of this issue of TIME is not news to those of us who have lived and tried to survive in the labyrinthine, opaque U.S. health system, receiving reams of bills and explanations of benefits from insurance companies, hospitals, doctors, labs, and ancillary health providers.
For those readers of the piece who hadn’t yet connected the dots between industry, providers, and policymakers, the research will erode trust that people might have felt with the U.S. health system at large.
There is something of a hero in the long story. After reading this piece en toto, we gain more respect for Medicare and its success at bending the cost curve for enrollees. So consider the Big Hairy Idea to lower the Medicare enrollment age…or open the program up to all-comers who want to buy-in.
The key Hot Point here is: go spend your post-tax, hard-earned dollar, buy and read this magazine cover to cover. You can click on the website and explore if you want, but in this case, I think TIME and Mr. Brill have earned their salaries.
The graphics alone are worth the price of admission and provide a pictorial portfolio of the heinous mark-ups on the average U.S. hospital bill.
We cover all of these issues here on Health Populi, one day at a time, one datapoint at a time. In this issue of TIME, you get the entire enchilada served up. It’s a stunning, brilliant, jarring synthesis worth your own time.