In less than a week since its release, Steven Brill's America's Bitter Pill has made headlines across the web. The New York Times calls it "an energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy," while others have criticized elements of the book.
One of those critics is Malcolm Gladwell, who calls the book "problematic." Specifically, Gladwell references Brill's "solution" to our healthcare struggles, in which Brill suggests regional healthcare systems also take the step to insure their patients. By doing that, Brill writes, the healthcare system will be streamlined and patients will no longer be price gouged by hospitals.
Gladwell disagreed in his review for The New Yorker:
It’s at moments like this that Brill’s book becomes problematic. The idea he is describing is called integrated managed care. It has been around for more than half a century—most notably in the form of the Kaiser Permanente Group. Almost ten million Americans are insured through Kaiser, treated by Kaiser doctors, and admitted to Kaiser hospitals. Yet Brill has almost nothing to say about Kaiser, aside from a brief, dismissive mention. It’s as if someone were to write a book about how America really needs a high-end electric-car company that sells its products online without being the least curious about Tesla Motors.
In a HuffPost Live interview Monday, Brill fired back at Gladwell.
"It would've been nice if he'd read the book," Brill told host Alyona Minkovski. "Because I do talk about Kaiser Permanente in the book. Kaiser Permanente is not the same because it doesn't have a monopoly, or oligopoly power, in any of its communities. It's not a teaching hospital. It doesn't have the network of high-quality doctors, or isn't perceived to, that something like a New York Presbyterian has in New York or the Cleveland Clinic has in Cleveland."
"He just got that wrong," Brill added.
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