Required reading for everyone who lives in the United States, or who is thinking about doing so: Steven Brill delivered an amazing piece of investigative journalism in February 2013 on the U.S. health care system in Time Magazine. Hopefully everyone will read it before they develop a serious illness, but regardless it lays bare some of the reasons why the health care economy makes absolutely no sense. That in itself wouldn't be a problem, but it's also bankrupting individuals and the entire country, which is really a shame.[We have updated this post to correct the spelling of Steven Brill's name, but also to republish it to keep this important topic in the public eye on an ongoing basis –Ed.]
If you have ever consumed health care at a hospital and looked at the bills that resulted, you will instantly relate to his 36-page analysis of six hospital bills. But he documents in no uncertain terms the sheer brazenness of a health industry that sets prices arbitrarily, applies them unevenly, and often collects on ridiculous charges unmercifully.
I am hoping that this piece sets into motion a sea change where Americans demand in the health care economy basic things that are required in every other economy. But in a market where
the consumers (people with sudden severe illness) are really not free to shop around, I think hospitals should be held to a standard of transparency and ethics that are higher than, for example, the grocery store industry.
The article is here: Bitter Pill Why Medical Bills are Crushing Us, in Time Magazine.
YouTube: Video from Time Magazine on his article.
Brill's conclusion that we should simply expand Medicare to fix this problem is probably wrong. But he exposes some very fundamental flaws that every consumer should be aware of before they head to any hospital for anything, inpatient, outpatient, lab, imaging, surgical, or emergency.
He talks about billing advocates that helped people cut their bills after the fact. But it's also critical to have a doctor who's aware of the cost issue and can help you navigate before and during a health crisis. We are experts of this at My Doctor Medical Group in San Francisco, and it's one of the reasons our patients go out of network to choose us for primary care. After all, the costs of outpatient care are tiny compared to hospital care, and it's often a worthwhile investment to have a doctor on your team who works for you, not your insurance company, when the chips are down.