By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    HIPPA compliance
    How Medical Office Staff Can Make Your Practice HIPAA Compliant
    October 29, 2021
    Everything you need to know about hyaluronic acid treatment
    Everything you need to know about hyaluronic acid treatment
    February 10, 2022
    Which Mushroom Capsules Are Good for Your Health?
    May 5, 2022
    Latest News
    Clean Your Mattress Properly to Avoid Common Health Issues
    March 29, 2023
    5 Benefits Of HIPAA-Compliant Answering Services
    March 28, 2023
    3 Ways To Deal With Health Issues In Cities With High Pollution
    March 22, 2023
    What Tools Should Your Caregiver Have?
    March 22, 2023
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    Health Care Inflation
    May 17, 2011
    Uninsured, and Lovin’ It
    June 10, 2011
    Health Care Reform in 2 Short Sentences
    July 21, 2011
    Latest News
    What Are Bioidentical Hormones Made With?
    March 23, 2023
    Cover Medical Costs of Child Dog Bites with Legal Specialists
    March 23, 2023
    3 Ways to Improve the U.S. Healthcare System By 2030
    March 14, 2023
    6 Steps To Ensure Speed And Efficiency Of Clinical Studies
    March 14, 2023
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: More Medical Monopoly: How Steve Brill Got It Wrong
Share
Sign In
Notification Show More
Latest News
healthy travel tips when visiting Australia
7 Essential Tips to Stay Safe and Healthy Visiting Australia
News
health risks of dirty mattress
Clean Your Mattress Properly to Avoid Common Health Issues
Health
eligble for NDIS?
Are You Eligible For NDIS? How To Apply
News
upgrade to your nursing career
4 Pertinent Ways to Upgrade Your Nursing Career
Nursing
career in nursing
8 Keys to A Fulfilling & Successful Career in Nursing
Career
Aa
Health Works CollectiveHealth Works Collective
Aa
Search
Have an existing account? Sign In
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Business > Finance > More Medical Monopoly: How Steve Brill Got It Wrong
BusinessFinanceHealth ReformHospital AdministrationPolicy & Law

More Medical Monopoly: How Steve Brill Got It Wrong

MightyCaseyMedia
Last updated: 2013/03/01 at 9:00 AM
MightyCaseyMedia
Share
0 Min Read
health_insurance_medical_costs: Alec
SHARE

health_insurance_medical_costs: AlecI talked about Steve Brill’s epic TIME piece health_insurance_medical_costs: AlecI talked about Steve Brill’s epic TIME piece Bitter Pill: Why Medical Bills Are Killing Us last week. I’m still absorbing the cost data he uncovered in that piece, and the graphics and images alone are worth the $5.99 cover price to get a physical copy of the magazine. The stories he shares, and the healthcare industry’s Great & Powerful Oz – the hospital chargemaster price list – is indeed a big part of the out-of-control price spikes in US healthcare.

As brilliant, informative, and galvanizing as Brill’s piece is, I believe he dropped the ball just short of the goal line when, in his wrap-up recommendations, he talks up solutions that nibble around the edges of the cost problem, but don’t address its core cause: our crazy 3rd-party payer system. Take a walk with me through the hallways of US healthcare history. Here’s the timeline:

  • 1880s: Chloroform in use as surgical anesthesia (thank GOD).
  • 1900s: The American Medical Association (AMA) becomes a big player.
  • 1900s: Doctors no longer work fee-free in US hospitals (see bullet #2).
  • 1910s: America lagging behind European nations on health insurance (already?).
  • 1920s: Political complacency (must have been all the bathtub gin) leads to a “what, me worry?” attitude toward rising medical costs.
  • 1930s: Oops, we broke the stock market. Blue Cross, against insurance industry advice, starts offering hospital insurance coverage.
  • 1940s: Stiff wage controls in WWII defense plants leads to employers offering health insurance to their factory workers. President Truman draws up national health insurance plan, gets beat up on the White House lawn by Congress.
  • 1950s: Pharma industry becomes big player via antibiotic and vaccine development, along with meds for a variety of illnesses. Lots of proposals for national health plan, all get beaten up in public and sent home. Employer-based group insurance plans, offering coverage for “major medical” (hospitalization), become the norm.
  • 1960s: First incidence of the idea of a “doctor shortage”. Hospital costs have doubled since the last decade. Specialist MDs now are 70% of working doctors. Medicare passed.
  • 1970s: First HMOs established (rending of garments and gnashing of teeth followed swiftly behind). Medicare expenditures are growing faster than predicted. President Nixon proposes national health plan, gets beaten up on the White House lawn by Congress, complains about it on Watergate tapes. Starts “War on Cancer” instead.
  • 1980s: In the Corporate Decade, corporations start to take over, consolidating hospitals and health systems. Medicare shifts to paying by diagnosis rather than by treatment, private insurers follow suit. Private insurers start complaining that “fee for service” is being exploited by healthcare providers, but say nothing about the corporatization of healthcare.
  • 1990s: Healthcare costs now increasing at double the rate of inflation. President Clinton attempts healthcare reform, gets beaten up on the White House lawn by Congress. 16% of US citizens now uninsured. The AMA starts up the RUC (Specialty Society Relative Value Scale Update Committee), a star-chamber group that sets pricing for medical procedures in secret and hands it to Medicare. Price-fixing? Nope, cause Medicare publishes the list, not the AMA.
  • 2000s: Medicare starts to be judged as unsustainable. The RUC is still working in secret. Healthcare costs rise 100% for the average family during the decade. Employer-based group health insurance faces economic challenges due to changing workforce demographics. Insurance premiums for health coverage double. Oops, we broke the stock market AGAIN.
  • 2010s: Obamacare passes. President Obama’s repeatedly beaten on the White House lawn by Congress, but he gets a few lick in himself. Obamacare is a fat, wet kiss on the lips for the insurance lobby; how it affects the rest of us is a still-open question. Word starts spreading about the RUC.

In Bitter Pill, Brill’s “big bad devil” is hospital profiteering via the chargemaster. He highlights the hospital lobby as the most politically powerful group in any Congressional district, and calls out the high salaries of hospital administrators as a big driver of overall healthcare costs.

He also recommends that pharma patents should be limited in their blockbuster-drug Monopoly game, and that medical malpractice caps need to be put in place – both of which I agree with 100%.

More Read

everest healthcare

The Everest Foundation’s Mission to Support Inclusive Healthcare

Colleges Prove the Huge Benefits of AI in Healthcare Education
Best Practices for Healthcare Call Centers Should Follow in 2023
How Hospitals and Other Healthcare Providers Can Boost Employee Morale
What are the Benefits of Hospitals and Clinics Using Expense Management Services?

However, Brill reserves most of his criticism for hospitals, and the chargemaster. I counter that the chargemaster arose as part of an overall structure problem in US healthcare: like the rest of US business, it’s bottom-line and shareholder-interest driven. Customers (commonly called patients) aren’t given a thought in the corridors of healthcare power other than as revenue units. And that’s because we aren’t directly paying the bills. It really is all about the dollars, and who hands them over, in a commercial transaction – healthcare, and everywhere else.

I’m not saying that doctors, and hospital administrators, need to work for minimum wage. I don’t think anyone should have to work for minimum wage – who could live on $7.75 an hour, which amounts to the princely gross sum of $310/week? What I do recommend is starting to put value into the equation for patients, not just for shareholders and employee bonus assessments. Healthcare customers – patients – need to be able to assess the value of the healthcare services they receive, beyond the fact that it might be saving their lives. Yes, that’s certainly a high-value item, but it’s not part of every healthcare encounter. Making that value apparent will require putting customers – patients – at the table for all parts of the healthcare conversation. Starting with (and yes, I know I’m a broken record on this) asking, always and everywhere, “How much is that?” when making a healthcare decision.

We also need to take a long, hard look at employer-based group insurance, and maybe put it out to pasture. I’m on record with my thoughts that we should all be buying our own insurance – when various groups shout about “job killers,” I wonder if they’ve ever had to buy group insurance for their employees. That’s a real job killer, right there. Access to cost information, hand in hand with outcomes information (available on Leapfrog’s hospital safety app and other outcome-metrics reporting tools), will reveal the value of a service.

That’s what will really reform the system: patients asking questions, and working to get the full answers to them. And killing off the RUC would be a great idea, too. Otherwise, we might as well go beat ourselves up on the White House lawn – hey, the Secret Service might help us out if we do.

TAGGED: employer-based group insurance, hospitals, price list

Sign Up For Daily Newsletter

Be keep up! Get the latest breaking news delivered straight to your inbox.
By signing up, you agree to our Terms of Use and acknowledge the data practices in our Privacy Policy. You may unsubscribe at any time.
MightyCaseyMedia March 1, 2013
Share this Article
Facebook Twitter Copy Link Print
Share
Previous Article fitness Hyponatremia – Overhydrating on the Trail
Next Article Image Flawed Data With Physician and Hospital Rating Sites

Stay Connected

1.5k Followers Like
4.5k Followers Follow
2.8k Followers Pin
136k Subscribers Subscribe

Latest News

healthy travel tips when visiting Australia
7 Essential Tips to Stay Safe and Healthy Visiting Australia
News March 29, 2023
health risks of dirty mattress
Clean Your Mattress Properly to Avoid Common Health Issues
Health March 29, 2023
eligble for NDIS?
Are You Eligible For NDIS? How To Apply
News March 29, 2023
upgrade to your nursing career
4 Pertinent Ways to Upgrade Your Nursing Career
Nursing March 29, 2023

You Might also Like

Bioidentical Hormones
Medical Education

What Are Bioidentical Hormones Made With?

March 23, 2023
child dog bite lawyer
News

Cover Medical Costs of Child Dog Bites with Legal Specialists

March 23, 2023
US healthcare system
Global Healthcare

3 Ways to Improve the U.S. Healthcare System By 2030

March 14, 2023
Clinical Studies
Global Healthcare

6 Steps To Ensure Speed And Efficiency Of Clinical Studies

March 14, 2023
//

We influence million of users and is the most authentic source of information on healthcare business and technology news.

Quick Links

  • About
  • Contact
  • Privacy
Subscribe

Subscribe to our newsletter to get our newest articles instantly!

Follow US

© 2008-2023 HealthWorks Collective. All Rights Reserved.

Removed from reading list

Undo
Welcome Back!

Sign in to your account

Lost your password?