Steve Brill on U.S. Healthcare

In 2009, Steve Brill wrote the article of the year, The Rubber Room, in the New Yorker, about NYC’s notorious rubber rooms for teachers accused of misconduct. The article was so accurate, well-researched, pointed, and devastating that it soon led to reforms (how meaningful is open to debate).

Brill is back with what I think will prove to be the 2013 article of the year about the only system in the U.S. that is larger, more wasteful, more broken, and more threatening to our future than our messed up K-12 public school system: our healthcare system.

It’s a very long article – the longest cover story in Time magazine’s 90-year history – but it’s hard to put down because it’s so heart-breaking and infuriating. We spend roughly TWICE the percentage of our GDP on healthcare, but get middle-of-the-road results (at best), with HUGE disparities – often completely random, but in general, of the MILLIONS of people completely screwed by this system, most are (surprise!) those who can least afford it – the exact opposite of those who are benefitting.

It is an immoral, disgraceful system that is bankrupting us – and both political parties are to blame. There are no easy solutions – this is where Brill’s article is weakest – but I must say I’m much more impressed with Medicare than I was.

Brill was on the Daily Show (Part 1, 2, 3) and Charlie Rose this week 

Here’s an excerpt:

When you look behind the bills that Sean Recchi and other patients receive, you see nothing rational — no rhyme or reason — about the costs they faced in a marketplace they enter through no choice of their own. The only constant is the sticker shock for the patients who are asked to pay.

Yet those who work in the health care industry and those who argue over health care policy seem inured to the shock. When we debate health care policy, we seem to jump right to the issue of who should pay the bills, blowing past what should be the first question: Why exactly are the bills so high?

What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?

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