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America’s Bitter Pill – A Book Worth Reading

Posted by Matt Humphrey Friday, May 1, 2015 11:41:00 AM

by Mark Gothberg

The incredibly high cost of healthcare that continues to spiral upward each year. Millions of Americans, including those with pre-existing conditions that insurance companies are reluctant to cover, without access to affordable healthcare. A financial reimbursement system that rewards healthcare providers to see more patients, order more tests, and perform more procedures rather than focus on the long-term well-being of consumers. Malpractice tort reform that is way over-due. These were among the many important issues that the Affordable Care Act, or Obamacare, was intended to address.

More than five years after the reform law was passed and well over a year since critical aspects of the law took effect, Obamacare remains a hot issue. What is clear is that more than 15 million people are now being covered under Obamacare. Still the law is unlikely to bend the healthcare cost curve. To better understand why the law failed to achieve many of its goals and why the launch of the national health exchange was a disaster, you should read Steven Brill’s newly published book, America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System.

Brill is known for his Time magazine Special Report on the nation’s healthcare crisis. In America’s Bitter Pill, Brill details in step-by-step fashion the many compromises and deals that were made with insurance and pharmaceutical companies, hospitals, physicians, and Congress to pull together a law that would expand health coverage while trying to offset the substantial costs involved, and at the same time, lower medical costs.

Particularly enlightening are sections that discuss why the national healthcare exchange was so problematic, took months to correct, and ended up costing some $840 million – triple the original budget. In contrast, Kentucky’s health exchange, Kynect, cost just $154 million, including marketing costs, and was a success from day one. There are many great lessons here for Web and digital e-health managers.

Brill believes further reform will be necessary to address our healthcare crisis. His key recommendation is that the federal government should both encourage the formation of big, integrated health systems and establish specified safeguards to ensure that such systems, which have their own insurance components, align quality care with lower costs. The benefits and shortcomings of such a scenario, and the ways to prevent abuse, will consume many hours of discussion around water coolers.

Mark Gothberg is Chairman of the eHealthcare Leadership Awards and has been reporting on healthcare marketing and business development for more than 25 years.


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