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The ‘Bitter Pill’: Time’s Steven Brill on ‘Why Medical Bills Are Killing Us’

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Steven Brill’s Special Report in the current issue of Time is lengthy, but well worth the read, whether or not you agree with his analysis.

Bitter Pill: Why Medical Bills Are Killing Us contains a lot of useful information, including from research and studies, as well as from the experiences of individuals and families dealing not only with health issues, but with a medical system that often, in my words, treats health care as a product, not a human right.

An excerpt: (emphasis added throughout)

According to one of a series of exhaustive studies done by the McKinsey & Co. consulting firm, we spend more on health care than the next 10 biggest spenders combined: Japan, Germany, France, China, the U.K., Italy, Canada, Brazil, Spain and Australia. We may be shocked at the $60 billion price tag for cleaning up after Hurricane Sandy. We spent almost that much last week on health care. We spend more every year on artificial knees and hips than what Hollywood collects at the box office. We spend two or three times that much on durable medical devices like canes and wheelchairs, in part because a heavily lobbied Congress forces Medicare to pay 25% to 75% more for this equipment than it would cost at Walmart.

Medicare, you’ll remember, was one major focus of the anti-Obamacare Tea Party actions, with the memorable, “Keep the government out of my Medicare” signs.

Another snippet, with a few numbers about just how “government” is “in” Medicare:

According to the Center for Responsive Politics, the pharmaceutical and health-care-product industries, combined with organizations representing doctors, hospitals, nursing homes, health services and HMOs, have spent $5.36 billion since 1998 on lobbying in Washington. That dwarfs the $1.53 billion spent by the defense and aerospace industries and the $1.3 billion spent by oil and gas interests over the same period. That’s right: the health-care-industrial complex spends more than three times what the military-industrial complex spends in Washington.

An obvious question is, will things improve with Obamacare? Brill examines a number of suggestions toward improving our bloated health care system, and concludes:

None of these suggestions will come as a revelation to the policy experts who put together Obamacare or to those before them who pushed health care reform for decades. They know what the core problem is – lopsided pricing and outsize profits in a market that doesn’t work. Yet there is little in Obamacare that addresses that core issue or jeopardizes the paydays of those thriving in that marketplace.

Obamacare, he writes, “does some good work around the edges of the core problem,” related to limiting “abusive hospital-bill collecting,” requiring the use of “plain English” in insurance policies, and a “more rigorous appeal process” in the case of denial of coverage.

These are all positive changes, as is putting the insurance umbrella over tens of millions more Americans – a historic breakthrough. But none of it is a path to bending the health care cost curve.

Health insurance reform isn’t health care reform. I’m glad for every bit of “good work around the edges” that Obamacare provides. But the system that drives the cost, and the degree of accessibility to good health care, is still in place.

(Time’s Bitter Pill Cover via Time)

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