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Bitter Pill: Why Medical Bills Are Killing Us

by Steven Brill

What are the reasons, good or bad, that cancer means a half-million- or million-dollar tab? Why should a trip to the emergency room for chest pains that turn out to be indigestion bring a bill that can exceed the cost of a semester of college? What makes a single dose of even the most wonderful wonder drug cost thousands of dollars? Why does simple lab work done during a few days in a hospital cost more than a car? And what is so different about the medical ecosystem that causes technology advances to drive bills up instead of down?

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If you are confused by the notion that those least able to pay are the ones singled out to pay the highest rates, welcome to the American medical marketplace.

Faith Healers

by Cienna Madrid

Sure, in 43 pages of Ethical and Religious Directives, there’s some common-sense guidance to be found. But they’re also flush with horrifying detail. As you’d expect, the directives pertaining to women’s fertility read like a misogynist romance novel or found art from the Middle Ages: “Catholic health institutions may not promote or condone contraceptive practices.” Emergency contraception can only be given to rape victims, and even then only “if, after appropriate testing, there is no evidence that conception has occurred already.” Vasectomies and tubal ligations are also prohibited. Egg and sperm donors are deemed “contrary to the covenant of marriage,” surrogate motherhood is prohibited because it denigrates “the dignity of the child and marriage,” and doctors at Catholic hospitals can’t help infertile couples conceive artificially—using their own eggs and sperm—because test-tube babies “separate procreation from the marital act in its unitive significance.”

Then there’s this: “Abortion… is never permitted.”

Not even when the egg attaches outside the uterus and puts a mother’s life in danger: “In case of extrauterine pregnancy, no intervention is morally licit which constitutes a direct abortion.”

The Extraordinary Science of Addictive Junk Food

by Michael Moss

In his capacity, Dunn was making frequent trips to Brazil, where the company had recently begun a push to increase consumption of Coke among the many Brazilians living in favelas. The company’s strategy was to repackage Coke into smaller, more affordable 6.7-ounce bottles, just 20 cents each. Coke was not alone in seeing Brazil as a potential boon; Nestlé began deploying battalions of women to travel poor neighborhoods, hawking American-style processed foods door to door. But Coke was Dunn’s concern, and on one trip, as he walked through one of the impoverished areas, he had an epiphany. “A voice in my head says, ‘These people need a lot of things, but they don’t need a Coke.’ I almost threw up.”

The Higher Health Insurers’ Claim Denial Rate, the Higher the CEO Pay

by Wendell Potter

One of the things you need to know about the private health insurance business is that insurers make a lot of money when they delay paying a claim. … When an insurance company delays paying a claim by days, weeks or months, it can take advantage of “float.”

The longer you can delay paying a claim, the more investment income you can make on the premiums you take in from your policyholders. And investment income is especially important to for-profit insurance companies because it contributes significantly to the bottom line. Shareholders and Wall Street financial analysts like that, even though much of the money on which the investment gains were made should have been paid to health care providers.