Father William Byron, S.J.

The future of print journalism is by no means clear, particularly in the case of weekly newsmagazines. Newsweek is no longer available in print. How long Time magazine will continue to be available on newsstands is anyone’s guess.

But whatever the future holds, the March 4, 2013, issue of Time will be long remembered for doing what great journalism should be doing, namely, providing facts and analysis on important topics of current interest. In this case, Time’s cover shouts out, “Bitter Pill: Why Medical Bills Are Killing Us,” announcing the 24,105-word feature story by Steven Brill (said to be the longest piece that Time has ever published). I hope that this augurs well for a healthy print future for Time. But who can say?

This report is much less about who should pay for health care (as the current political debate tends to frame the question) and asks instead: Why are we paying so much? The annual tab amounts to nearly 20 percent of our gross domestic product, far more than other industrial nations pay for equally good or even better health care. Those who take time to think about the issue find themselves concluding that this situation is simply outrageous.

If anything is to be done about it, the public must become better informed (thank you, Time!) and the information must, in turn, prompt wiser consumer choices and better regulatory policies, not to mention higher standards of medical and business ethics for health care managers, insurers, and providers, manufacturers of medical devices and pharmaceuticals, and both legislators and lobbyists.

Health care is a $2.8 trillion annual market and that market is by no means free. And many of the so-called not-for-profit hospitals are seeing their revenues far exceed their costs. Isn’t that, by definition, profit?

Those in need of health care want the best but rarely know what it is going to cost. They don’t care because the insurer (assuming they are insured) will cover it. Similarly, those who provide care want to provide the best and they, too, are not preoccupied with cost as they look at the patient because both patient and provider look to third-party payers. Health care is a seller’s market.

Hospital bills tend to be indecipherable. Brill, an intelligent and nonideological journalist, leads the reader by the hand to “follow the money” and he deciphers the bills while explaining how disproportionately high prices can be relative to actual costs. Medicare comes off well in this analysis, although suggestions are made for revisions to Medicare that will lower overall costs.

The villain in this piece is the “chargemaster,” the internal price list that all hospitals have and few, if any, hospital administrators are willing to explain. It sets the price for every pill and procedure and seems to be applied blindly and uncritically by the very hospital administrators who plead ignorance of how any given number found its way onto the list.

If you can figure it out, you are on your way to getting a handle on the question Time raised: why medical bills are killing you. More of us have to get interested in that question if all of us are to enjoy a more secure economic and medical future.


Jesuit Father William J. Byron is university professor of business and society at St. Joseph’s University, Philadelphia. Email: wbyron@sju.edu.