INTERVIEW: Journalist Steven Brill on health care costs

As we prepare for the 2018 Lown Conference in April, we want to help you get ready as well. So we’re putting out interviews with some of our keynote speakers so you learn more about what to expect at the conference, and start getting excited!

Here’s an interview with prominent journalist and lawyer Steven Brill, who will be giving a “fireside chat” at the Lown Conference. Brill is the author of the 2015 New York Times Bestseller, America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System and the article, “America’s Most Admired Lawbreaker,” about Johnson & Johnson’s 20-year practice of illegally marketing a powerful drug to vulnerable patients.

Lown Institute: You’ve written previously about many topics, including law, education policy, and national security. What made you want to start writing about health care?

Steven Brill: I got into writing about health care because I didn’t know anything about it. During the Obamacare debate there was a lot of discussion about how to insure people against high cost of health care. But no one was asking the first question – Why does health care cost so much?

Lown: What was it like to dive headfirst into health care when you weren’t familiar with the topic?

Brill: I don’t get intimidated by not being an expert, I just read a lot about it and become an expert. When I was writing the Time article that later became America’s Bitter Pill, I was looking to follow the money. And the way I did that was go through every line in the medical bills and ask, Why does this drug cost so much? Who gets this money?

Lown: What are you planning on talking about in your conference keynote?

Brill: I want to start a discussion about the current policy landscape and bring cost into focus. In the entire debate over “repeal and replace” that we had earlier this year, there was nothing proposed to address the cost of healthcare – drug prices, hospital profits, etc. In fact, the Trump administration has gone in opposite direction, getting rid of mandatory bundling [a value-based care initiative from Obamacare].

Lown: What types of proposals would you like to see to control costs?

Brill: I think the only realistic idea to change all this, would be to lower the age of Medicare eligibility by 2 years every year for next 20 years. That would give us Medicare For All within 20 years – a very gradual process but you can’t do it all at once.

At the same time, we have to provide the incentives and the management to provide better care. We tend to overtreat because of incentives, but to me, the cost issue boils down to this very simple proposition – “All the prices are just too damn high.”