Hospitals, Policy

A healthcare journalist who unexpectedly needs emergency surgery sees the heart of the system

Journalist Steven Brill was busy covering the politics of the American healthcare system when he […]

Journalist Steven Brill was busy covering the politics of the American healthcare system when he himself had an unexpected medical emergency, which required him to get heart surgery.

“There I was: a reporter who had made hospital presidents and hospital executives and health care executives and insurance executives sweat because I asked them all kinds of questions about their salaries and about their profit margins,” Brill told NPRs Terry Gross. “And now I was lying on a gurney in a hospital in real fear of my life.”

For Time he had written the National Magazine Award winning article Bitter Pill: Why Medical Bills Are Killing Us before he got slammed with his own hospital bills, and now the experience has led to his book America’s Bitter PillThe book takes a close look at how the Affordable Care Act works, which came as a result when healthcare overhaul was challenged due to pharmaceutical and medical industry lobbying.

Thankfully Brill had health insurance that covered most of his expenses (about $178,000 of the entire $190,000 bill). And thankfully a lot of uninsured people will now get coverage because of the ACA, but it’s not that simple, as he points out. Things get kind of complicated.

Brill addresses the fact that insurance billing reports are frankly nonsensical in some cases. Even the CEO of United Healthcare couldn’t explain why one of Brill’s bills said what it did. But he makes a case for why it’s not the insurance companies’ fault – and he feels sorry for them.

The culprit here — and the reason that the Affordable Care Act doesn’t work is, is not going to work — is that nothing has been done to curb the marketplace of exorbitant bills and exorbitant profiteering on the part of hospitals, medical device makers and obviously the drug companies. The insurance companies are as much the victim of that as we are.

Now, they’re terribly managed; again, the CEO of the largest company can’t even explain what his bill means. They’re incompetently managed; they’re not very nice people when you get them on the phone. But they’re sort of stuck in the same ditch we’re in, which is being forced — unlike the payers for health care in any other developed country on the planet — being forced to pay uncontrolled, exorbitant prices and high profits that are generated by nonprofit hospitals and by drug companies and medical device makers.

Brill also addresses unregulated prescription drug prices and how the ACA affects hospitals, taxes, and whether or not Obama’s plan is reasonable.

“It is great that more people are getting health care, but we cannot continue to be a country where health care prices are 40, 50, 60 percent higher than they are in every other country where the health care results are as good, or better, than ours,” he said. “It’s unsustainable.”

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