NEW YORK TIMES BOOK REVIEW: …“America’s Bitter Pill” is an energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy. It is full of insights, contradictions, apologias, flashes of anger, tidbits of history, extended stories of awe, compassion, some glibness and moments of brilliance. Above all, it includes fascinating reporting on how crucial decisions were made involving the drafting and implementation of the Affordable Care Act…
“America’s Bitter Pill” presents a personality-driven view of historical change, including the temperaments and accidental moments that affect history, like the ill-timed December vacation of Martha Coakley, who was running against Scott Brown for Kennedy’s Senate seat. But two of the book’s more powerful insights have to do with matters of industrial or bureaucratic structure. The first involves the health delivery system. Many people tend to look with alarm at consolidation in the insurance industry, and they focus on insurance company lobbying power as the essential cause of rising prices. One of Brill’s critical insights is how consolidation in the hospital industry has actually decreased insurer power relative to provider power: Much of the rising cost of health care comes from overcharging by hospitals, not insurers.
“America’s Bitter Pill” presents a personality-driven view of historical change, including the temperaments and accidental moments that affect history, like the ill-timed December vacation of Martha Coakley, who was running against Scott Brown for Kennedy’s Senate seat. But two of the book’s more powerful insights have to do with matters of industrial or bureaucratic structure. The first involves the health delivery system. Many people tend to look with alarm at consolidation in the insurance industry, and they focus on insurance company lobbying power as the essential cause of rising prices. One of Brill’s critical insights is how consolidation in the hospital industry has actually decreased insurer power relative to provider power: Much of the rising cost of health care comes from overcharging by hospitals, not insurers… (more)
EDITOR: We will purchase, read and report on what sounds like a fascinating study of the creation of the Affordable Care Act, its plusses and its minuses
What bothers us so much are right wig ideologue who know little about the Act except: 1) Richard people may have to pay a bit more for coverage; 2) Come 2017, the Republic president and Republic House and Senate will repeal it. Both of which are utter nonsense.
But ignorance has never deterred the right wing’s certainties.
Any solution to the problem would have to include a limit on the income and number of hospital administrators and insurance company profit. The current system pays the middle man about half of the pie. Also there are games played by the insurance to increase the amount they keep.
The hospital, if it were the insurance company, would be better equipped to play the same games.
Also an absolute lower limit on how much money should go for direct patient care and a transparency in fairness in pharmacy pricing with loss of patent being a threat for windfall profiteers.