I just had to write about Steve Brill’s article, Bitter Pill, in this week’s Time magazine (Brill, 2013). This long examination of health care billing practices makes many, many telling points, but there are three that are most relevant to me.bitter pill

First. Many other countries in the world provide better health care to their citizens at much lower cost. A short list of countries who do it better for less: Argentina, Australia, Canada, Chile, France, India, Spain, Switzerland.

Second. Solutions to our health care issues are focused around paying for health care and not how it is priced. There is apparently no competition in the American free market when it comes to health care. My laptop computer is a marvel of science and technology and costs one tenth of what something vaguely similar would have cost 40 years ago. Modern health care has advanced also since the 1960’s but it has become vastly more expensive rather than less.

Third. Medicare is amazingly efficient and with its marketing power only pays what it actually costs providers to provide. Everyone whines about Medicare’s levels of reimbursement (See section 4 of Brill’s article on page 43) but a quote from Jonathan Blum says, “Hospitals don’t lose money when they serve Medicare patients” (page 47). I explored the potentials of Medicare as a profit center in Capitalism Abhors a Vacuum (http://wp.me/pH3Dx-9t).

Brill in the end recommends that the American health care system get serious about reducing costs and avoid the government provider systems typical in those example countries above.

I’m less optimistic. I say nationalize the whole lot.


Brill, Steve. Bitter Pill. Time, 2013, March 4, 181, 8, 16-55.

Image: Could not locate original source.

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