A Bitter Pill

The tone of the debate over healthcare reform in Congress was predictably partisan.  But the tone of the public discourse over healthcare costs is taking a different, more visceral, and frankly darker tone.  If you haven’t yet read the recent cover story called “Bitter Pill Why Medical Bills Are Killing Us,”, I urge you to do so.  (If, like me, you get most of your news from The Daily Show with Jon Stewart, you can watch the interview with the author, Steven Brill.)  It’s not so much because of its original insights (you probably already realized a lot of what is reported), or because it is so factually accurate (a little more on that below).  But the article is a stark reflection of how the majority of Americans view the absence of value in our healthcare system.

The 38-page article documents the stories of six people’s medical bills, the associated sticker shock, and the apparent arbitrariness and irrationality of charges and payments for medical supplies and services.  As I read the article I found myself getting a bit defensive.  Don’t people understand about the need to subsidize care for uninsured or underinsured patients?  How can they complain about salaries in the healthcare field – have they seen what people on Wall Street get paid?  And, as documented by others (e.g., Joanne Conroy in the Huffington Post), some of the facts are a bit distorted.

But in broad strokes, this article makes a case that many others have made before – healthcare in this country is very expensive, and while some of it is because we utilize a lot of it, much of the reason is that hospitals and medications and tests and yes, physicians, cost a lot.  A recent blog in the Washington Post called health care prices “ludicrous.”  And as healthcare consumes an increasing and unsustainable portion of our economy, and individuals find they can’t afford the care they need, there is going to be a backlash.  We can rationalize and explain, but more and more people are just fed up.  This is why we all need to read and pay attention to this article; what I sensed was anger, more than anything else.  I’ve heard that anger in some of our families who complain about their bills.  I’ve heard it in conversations at parties.  I’ve heard it from business leaders talking about their healthcare costs.  I’ve heard it among commentators both serious and comic (Jon Stewart was in rare form about this).  To those who wonder if all the talk about change in the healthcare system is overwrought, and think it will all blow over in a few years like HMOs did in the 1990s, I would say this feels very different.  If we want to play a meaningful role or even drive the reforms, we need to acknowledge the passion, the frustration, the rage, before it is turned on us.

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