Notes From the Fieldby Martin Weil

March 1, 2013

A Must Read

Bitter Pill: Why Medical Bills Are Killing Us, Time magazine’s cover story on healthcare, should be the one thing every American reads this year. Author Steven Brill concludes that we have been debating entirely the wrong question. It is not “Who should pay for healthcare” that we should be arguing about, but ‘Why healthcare in the US costs so much more, for the same or less result, than in any other developed nation?”

Brill finds a healthcare delivery and billing system rife with conflicts of interest and incentivized to increase costs. It is a system where providers have all the cost and pricing information. Consumers have little bargaining power, and third party payers are losing theirs. Over-provision of services is not just common, it is the norm, as is a fantastical concept called the “Chargemaster.”

Brill’s is a long article but written with the depth of research and clarity you would expect in a book, not a news magazine article. Anyone concerned about the cost of healthcare, or our nation’s finances, needs to read it.

At nearly 20% of GDP, the cost of healthcare in the US acts as a brake on our productive capacity. And it is a major contributor to our government’s deficit with Medicare/Medicaid now representing 24% of our Federal Government’s spending. Healthcare is one of the few budget areas that is not shrinking. The only way we are going to get our national debt problem under control will be to address face-on our structural problem with healthcare delivery and finance. To do that will require a body politic and a public ready to face some difficult truths.





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