National Commentary

On Health Care’s Violation of Trust

The unusually high number of eye-popping scandals swirling around among the page one headlines these days, including the many speculations about why the Pope really quit (I’ll have more to say about that later), make it challenging to prioritize. Is it the Great Sequester, the once-every-600 years Papal resignation, the latest revelations about what is really going on in Afghanistan, or official U.S. drone-kill policy? Which among these matter the most?

Or, is it that the President mixed fantasy world metaphors when he referenced a “Jedi mind meld” in his remarks about the Sequester last week? (For a nation that has been rendered impotent and passive by years of “mind melt” cultural and intellectual degradation, this, of course, is the subject of most of the concern and conversation.)

Less publicized was the report last week that the Afghan government formally ordered U.S. troops out of the Helmand province of south central Afghanistan. The order came one day after a BBC report aired globally about conditions BBC journalists traveling with U.S. support troops found there. The report cited rampant corruption, including the Afghan military ordering spare parts for scores of totally-demolished vehicles piled in a parking lot, drug abuse (the province is reportedly one of the worst for poppy production) and the practice of using and abusing so-called “chi boys.”

In the latter case, the practice, which smacks of some of the problems confronting the Vatican, is apparently widespread in Afghanistan, the subject of a PBS Frontline special, “The Dancing Boys of Afghanistan,” that aired last year. It involves the sexual exploitation of young boys by powerful older men, including those in the Afghan military. Hardly done in secret (except to the outside world), external manifestations of this practice were filmed by the BBC crew going on out in the open among the Afghan troops.

Vatican-like, the response of the Afghan government was not to denounce and help in the prevention of such child-rape practices, but to order the investigation to stop.

Beyond this, but an even greater indictment of the sordid world we live in today, the biggest scandal of the week is contained in the blockbuster report by Steven Brill about the nation’s $2.8 trillion health care market that filled the pages of the March 4 edition of Time magazine, entitled “Why Medical Bills Are Killing Us.”

To quote Time’s managing editor Richard Stengel, “For the first time in our history, we are devoting the entire feature section of the magazine to a single story by one writer: a powerful examination of America’s health care costs. The 24,105 word story, reported and written by Steven Brill, inverts the standard question of who should pay for health care and asks, instead, Why are we paying so much?”

Stengel added, “Have you actually looked at your hospital bill? It’s largely indecipherable, but Brill meticulously dissects bills and calculates the true costs. He employs a classic journalistic practice: he follows the money, and he does it right down to the 10,000 percent markup that hospitals put on acetaminophen.”

Brill, according to the magazine, spent seven months deciphering such hidden costs in hospital bills, and the report is startling and, one would hope, may mark a sea change in both the conversation about and practice of health care in the U.S. today.

It could have the same impact that a single edition of Life magazine had in June 1969, long prior to the publication of “Pentagon Papers,” credited with causing a major turn in American public sentiment toward the Vietnam war. Over the protests of the U.S. military, with the front page headline, “The Faces of the American Dead: One Week’s Toll,” the magazine reprinted in a high school yearbook format 12 pages of 242 mostly 18-to-20-year-old boys killed in one week in Vietnam.

Time’s exhaustive article could generate a similar effect. Needless to say, the rich and powerful in the industry, including in the pharmaceutical industry, will do their best to gloss over the report, to dismiss it with dissembling generalities. It’s also 44 years later, and maybe the public is numb to such glaring injustices by now.