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Review by Robert C. Tretter, CLU, ChFC, RHU Healthcare in the United States is a hotly debated topic. Whether it is in the halls of Congress, the workplace, or at home, we find ourselves discussing the availability, cost, and value of our health care. There are those who like to think that health care in other parts of the world is better, yet when questioned many of those people are just making assumptions based on something they read or heard. But there is no doubt that our healthcare system is a topic that will not go away since it affects us all. With the latest elections, healthcare and its many facets will be debated even more in the next few years. One of the advantages of being a past president of the National Association of Health Underwriters is that I get asked at times to review articles or books written by a member looking for feedback. Such was the case a short time ago when Bob Shupe sent me a copy of his book “The Bitter Pill”. I thought I knew quite a bit about our healthcare system, but what I discovered is that I didn’t know nearly as much as I thought! This book is an excellent tool in not only explaining the system, but delving much deeper into the causes for some of the problems (in fact, determining whether a problem is real or imagined). I found it rather unique and refreshing in that it did not attempt to place blame on one or two specific groups associated with the system, but instead took a more global view of things and tried to look at the issue from many different angles. Mr. Shupe does not assume that the reader knows how our current healthcare system evolved into what it is today. He does an excellent job of giving the reader a historical lesson on how things happened, and prefers to focus on the problems and not the symptoms. As consumers, we have become comfortable with our choices when facing healthcare concerns – who to see, when to see him or her, and the place we go to get our healthcare. Yet all of these tangibles have a great bearing on the ultimate cost of the system itself. These choices have roots that go back many years, and that is why giving the reader the historical perspective is so important. One of my favorite chapters is called “So, who are all the bad guys?” Depending on the group you are talking to, there is quick action to blame another party for the rising cost of health care. It could be the fault of the doctor, the insurance company, drug companies, state and local legislators, attorneys, insurance agents, employers, and yes – even the consumers. Mr. Shupe states a principal that I kept coming back to again and again – “health care costs are not high because insurance rates are high”. If you think about that, it seems so simple and true, yet many disgruntled users of the healthcare system will tell you that their health care costs are high because the insurance company charges too much for the plan. The author does a wonderful job of showing the reader that simply isn’t true – and he uses the analogy of buying a car at the used car lot to illustrate his point. Suffice it to say that after reading his analogy it makes great sense, because the fact is that neither the person buying the product or service nor the person selling them has a handle on the cost! Mr. Shupe then spend a great deal of time looking at the different “cost drivers” involved in the ultimate cost of health care. There are seven of them – the insurance company, the provider, pharmaceutical companies, state and federal legislators, attorneys, employers, and consumers. It is again important for me to state that no blame is directed at any one of these seven – instead, the author takes a pragmatic view of the role that each one plays in determining that ultimate cost. After reading each chapter that involved one of the seven, I found myself becoming quick to judge and react to that specific “cost driver”, only to read on to the next chapter and become judgmental at the next one. What that proved to me is that Mr. Shupe was doing a great job of illustrating the facts involving each group, and not trying to direct my anger at any one group. At the end of the day I realized (and I am sure it was his intention) that all are involved and responsible for what has happened to our healthcare system here in America. With that responsibility also comes the added accountability to be part of the solution. The rest of the book is a great manual for anyone who seeks medical attention here in America. Mr. Shupe describes medical spending habits and what can and should be done to change those. As he states in the beginning of Chapter 15, his book was not designed just to present a problem. It was designed to identify the problem and then give the reader useful tools to help manage health care costs. Some of these tools include things such as how the consumer can have some “skin in the game”, proactive lifestyle choices that we all can and should make, questions to ask when you go to the doctor, the emergency room, the hospital, and when you talk to your insurance company. It also describes what to do if you receive a letter or phone call from a collection agency. In summary, I believe that this is a “must read” book for anyone who is affected by what happens to the health care system in America – and that includes those who sell it, administer it, or use it. What sets this book apart is that it gets at the real roots of health care; that is, why we see benefits being reduced or even eliminated, and the high costs of having our health care system. What I especially found enlightening and refreshing is that it does not seek to place blame on a group or groups of people, but instead analyzes the problem globally and examines the self interests of each group involved. Before you make a final opinion of what is needed to fix our health care system in America I urge you to read this book! |
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