How to Fix the Healthcare Crisis

26 Feb

12 tactics for reining in an out-of-control industry: 


After reading Steven Brill’s engaging/appalling Time magazine article, “Bitter Pill: Why Medical Bills Are Killing Us,” about the rampant price gouging by the American healthcare industry (targeting people fearing for their health—or their very lives), I realized that the Maximum Know-How team needed to take on the issue to put things right.

The author’s path to uncovering moral corruption is commonly trod: Follow the money. But I disagree with his explanation that the problem is “lopsided pricing and outsize profits in a market that doesn’t work.” Really, it’s just plain selfishness and greed. A hospital charging $77 per gauze pad or $3 for one-time use of a reusable marking pen honestly can’t be considered anything else.

So how do we fix it? Brill’s realistic suggestions include things like tightening antitrust laws, outlawing the “chargemaster”—a hospitals’ price sheet of colossally exorbitant charges they affix to services and supplies—or taxing hospital profits at 75% (based on the belief that healthcare problems would subside if the government had more money to spend, or just because the government would put sick people’s money to better use than they could themselves). But we came up with some better ideas.

How to conquer the selfishness and greed of the healthcare industry:  

(These first two come from Brill himself)

  1. “Limit administrator salaries at hospitals to five or six times what the lowest-paid licensed physician gets for caring for patients there.”
  2. “Require drug companies to include a prominent, plain-English notice of the gross profit margin on the packaging of each drug, as well as the salary of the parent company’s CEO.”
  3. All hospital administrators must pay—out of their own salary—for every office supply they or their secretary uses. They are charged at their own hospital’s chargemaster rates: e.g., $3 for every single use of a ballpoint pen, $8 for each Post-It® note ($5 if generic brand), $65 for each phone call (local numbers only), $315 for each unsealed box of 300-count facial tissue (includes $15 recycling fee), $5,000 daily to sit in a room with a desk, chair, functional computer, and lighting.
  4. On an annual basis, call hospital executives before the senate committee in charge of “sentencing medical executives to prison for corruption” and have them explain each item in a randomly chosen patient’s bill.
  5. Drug companies who barter with people’s lives to ensure obscene profits must pay suppliers with a markup that matches their own. For example, just add a zero to the end. Or two.
  6. Put President Obama and his congressional backers on live television to explain what percentage of the healthcare reform bill they’ve actually read and what realistic good it will do. They must also defend the “unforeseen” repercussions that the entire country can see coming miles away. (Okay, this might not fix anything but it would sure feel good to watch them squirm.)
  7. Require any hospital manager exceeding a given annual salary (say, $150,000), to spend one day each week hand-delivering hospital bills to patients and then explaining and defending each cost.
  8. Considering that the healthcare industry spends about $360 million annually to lobby politicians, require that a thin slice of that amount fund signs in hospitals that accurately state your congressional rep’s payoff (“Hi, I’m Pinkerton Rumblebottom, your senator in Washington. As you stew impatiently in this emergency room, shackled by pain and paperwork, it’s important that you know I’ve taken $280,000 from healthcare companies to make sure your services here—and the meds you’ll need tomorrow—remain as expensive as possible! I did not approve this message.”)
  9. Permit patients to resupply the hospital with any materials used and receive a refund equal to that hospital’s chargemaster rates. For example, a patient can purchase a 500-count bottle of acetaminophen tablets for $10.00 or a 25-pack of sterile gauze pads for $5.00 and receive refunds of $750 or $1,925, respectively (minus a $5 restocking fee).
  10. As is done with cigarette packaging, require medical manufacturers and suppliers to include the average retail price and manufacturing cost of a comparable product so hospitals, doctors, and insurance companies can make educated purchasing decisions. For example, “Surgical tubing, 10-foot roll—Your price: $280 (available for $9.95 on; true manufacturing cost is 85¢).”
  11. Limit executive incomes for “non-profit” medical institutions to what the president of Doctors Without Borders pulls in.
  12. Require insurance company executives to navigate their own incomprehensible maze of red tape and doubletalk every time they want to receive a paycheck or get an expense reimbursed.

Now let me hear your ideas for correcting this wayward industry!


One Response to “How to Fix the Healthcare Crisis”


  1. New Olympic Sports for 2020 | Maximum Know-How - March 5, 2013

    […] that we’ve solved the healthcare crisis, let’s return to a pressing topic from a couple of weeks ago, namely the removal of wrestling […]

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