Last week, Time magazine published Steven Brill’s massive article on healthcare in our country.  It was the longest article ever published by the magazine that was written by one author.  Perhaps out of curiosity or perhaps as a challenge (or maybe because it beat shoveling snow) I took a peek at the article.  Once I started, I couldn’t put the article down.  It angered me, sickened me, scared me and embarrassed me all at the same time.  For 35 years I have made healthcare my life’s work and quite frankly I think we have created a monster.  Take a look at the article and see what you think.  If you make a living in the healthcare world it is not only important, but critical, that you are aware of these issues.

As Congress spends fruitless hours debating sequestration and governors build up the political courage to implement the Medicaid expansion in their states it is important to really look at the healthcare system.  We need to recognize how out of control things really are and how anyone with common sense could save billions of dollars by making just the simplest of decisions.  Ignore the spin you hear on both the left and right TV talk shows and really start digging into the facts.  If the facts as presented in this article are not true, or if they have been misrepresented, it is time for the hospitals to begin speaking out.

Is there anyone who thinks the markups on services and products as noted in the article are fair?  Does anyone think the idea of holding back chemotherapy until down-payments clear for incredibly inflated costs is fair?  Why are there such discrepancies between what Medicare pays and the rest of us pay?  Why do we give nonprofit status and allow entities to pay no taxes when they make so much “profit” and pay their leaders millions and millions?  Why do we allow these nonprofits to declare how much charity care they provide using incredibly inflated amounts for the services they provide?  Do we really think this is “fair market economics” when patients have no idea what they are paying for or why?  Does is seem a little like patients are making decisions with a gun to their heads?

Everybody is upset when they hear our country pays twice as much on a per person basis for healthcare and gets results that are middle of the road at best.  That is the data and it is confirmed by every reputable consulting group around.  We blame it on our “unique” population, poor diet or other lifestyle issues even though these arguments don’t play out when we compare ourselves to other developed countries.  The answer as to why our care is so expensive is clearly seen in this article.

How can this be fixed?  Our system is incredibly complex and we have huge amounts of money being spent making sure the current system stays in place.  Look how much negative publicity has been seen around the Affordable Care Act even though it is only attempting to make a minor dent in these issues.  Ignorance and fear run rampant around all the issues of healthcare and quite frankly that allows us to be exploited by those who profit from no change.  The simplest, yet most powerful, thing we could do is to offer Medicare to every person who wants to buy it in our country.  Everyone under the age of 65 would have to pay what it costs for coverage but at least they could buy into the program.  Everyone who has Medicare loves it and, because of their age, they are the sickest group in our society.  Note throughout the article how much could be saved if everyone just had to pay Medicare costs.  If non-government coverage is so much better then very few people or companies would take advantage of this option.  My bet is there would be massive change, as millions would move to Medicare.  Insurers, hospitals and others would be forced to change their business models and the free market would really begin to work again.  It is impossible to see the facts and not try to do something different.