Making noise all over the Twitt-o-blog-o-verse the past week was an extraordinary article by Steven Brill in Time Magazine (Time Magazine?!) entitled Bitter Pill: Why Medical Bills Are Killing Us. Longtime Loyal Readers™ of this blog will be unsurprised at many of the horrendous details to be found therein. But what makes it stand out as a piece of journalism is the dogged thoroughness of the investigative work coupled with a straightforward style of storytelling. Brill spent seven months analyzing bills from hospitals, as well as from “doctors, drug companies and every other player in the American health care ecosystem.” As the tales unfold from there, many of the absurdities that characterize U.S. healthcare come into crystal clear focus.
What emerges is not a very pretty picture.
Taking center stage are numbers. This is not as wonky as it sounds: numbers can paint pictures — vividly, and in stark detail. For example:
- 1 tablet of generic Tylenol on a patient’s bill: $1.50. “You can buy 100 of them on Amazon for $1.49 even without a hospital’s purchasing power.”
- Of Houston’s top 10 employers, five are hospitals.
- “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.”
It is here that we get to the why of it: “a heavily lobbied Congress.” Perhaps the most revealing numbers in the article are these:
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.
That is all on the first page of an 11-page tour de force; I urge you to read the whole thing.
I have said many times that healthcare for profit is evil. Reading Brill’s piece, it is hard to come away with any other impression than that healthcare for profit is also inane.