(Steven Brill is a Reuters columnist but his opinions are his
By Steven Brill
NEW YORK, March 26 1) Obama administration
malingers on hospital bill collecting abuses:
Here's a compelling story for any reporter who wants to
shine light on a failure of basic competence - or maybe it's
backbone - by the Obama administration on an issue that affects
millions of middle class and poor Americans and that was
supposed to be the president's number one priority.
In the article about healthcare prices that I wrote last
month for TIME, I reported that supposedly non-profit hospitals
not only charge ridiculously inflated prices (from a price list
called the chargemaster) to people who are uninsured or
underinsured, but they also routinely sue and demand that those
full prices be paid. It's a prime reason medical bills are the
cause of more than 60% of personal bankruptcies and even more
demolished credit ratings across the country.
However, one of the little-noticed provisions of Obamacare,
which was passed three years ago this week, requires that
non-profit hospitals, as a condition of keeping their tax exempt
status, must adhere to rules to be promulgated by the IRS that
would, among other things, not allow them to send bill
collectors or lawyers after patients except under certain
conditions. Those conditions include that the patients first be
informed through aggressive outreach efforts of the availability
of financial aid for patients unable to afford the bills and,
more important, that for patients whose incomes are below
certain levels, hospitals can only dun them or sue them for the
discounted amounts they usually charge insurance companies,
rather than the far higher chargemaster prices.
In theory, the IRS, which is a unit of the Obama
Administration's Treasury Department, could have promulgated
those regulations at any time after March 23, 2010, the day
Obamacare was signed into law. But the first draft of the rules
was not issued until two and a half years later - last summer.
And then the American Hospital Association's lobbyists pushed
back, calling the proposed rules "too prescriptive." (To me, if
anything, they seemed not prescriptive enough.) Since then,
nothing has happened. No final rules have been published. That
means that three years after the Obamacare signing ceremony in
the White House there is still no protection from hospital
lawyers and bill collectors for the patients least able to pay.
Any reporter who wants a legitimate gotcha story should ask
the people drawing salaries at the Tax Exempt Government
Entities division of the IRS and at its Chief Counsel's office,
as well as the Office of Tax Policy in the Treasury Department,
why it takes more than three years to write rules that would
immediately protect millions of Americans from the most
blatantly unfair aspect of our healthcare system. Or, next time
he has a presidential press conference, why not ask the man who
said health care reform was his highest priority?
2. Another story behind the Jay Leno story?
Yes, it's interesting that NBC is moving to replace late
night host Jay Leno with Jimmy Fallon. But to me what's more
interesting is how the entire story, which has made headlines
across the country and especially in New York, has relied wholly
on anonymous sources. The New York Times scoop last week by Bill
Carter - who wrote a best-selling book on the network's
late-night competition and seems to have access to everyone
involved - contained not a single named source.
Carter's lead, that "NBC has settled on two new stars for
'The Tonight Show': Jimmy Fallon and New York City," explained
that the news that Fallon was going to succeed Leno and move the
show to New York was "according to several senior television
executives involved in the decision." (By the way, how many is
"several"? Couldn't Carter at least tell us that?)
From there the sources became "the executives," "one senior
executive," "the executives," "many TV executives speculated"
(how many is "many"?), "two executives" and, finally, an "NBC
spokeswoman," who "declined comment on the move."
I don't doubt that the story is true. But I wish another
reporter would try to figure out who those sources were -
because that may be at least as interesting a story.
Here's why: Depending on who the sources are, the leaks to
Carter and others might either have been a concerted effort by
both the Leno and NBC camps to begin a gradual and trouble-free
transition, or they could have been the opening round in new
game of corporate back stabbing.
Interestingly, Carter never writes about whether he asked
Leno to comment. That seems to suggest that the leaks came only
from the NBC side, in which case they would be evidence of an
NBC effort to push Leno out early.
Carter writes that despite the fact that Leno is still
leading in the ratings, "many TV executives speculated that NBC
could not wait too long to promote Mr. Fallon, or it might risk
having Mr. Kimmel [Jimmy Kimmel, who is on ABC opposite Leno],
45, lock up the young adult viewers who are the lifeblood of
So, was Leno blindsided by the stories? Is this a reprise of
NBC's ham-handed effort in 2010 to juggle Leno and Conan
In short, the fact that all of these sources are anonymous
and don't seem to include anyone from the Leno camp suggests
that Carter's story should become part of another fun story:
"Network Moves to Push Out Popular Late Night Star Without
3. What do you have to do to get fired in Washington?
The week before last the Washington Post reported that the
federal General Services Administration "was orderedto
reinstate a senior executive who lost his job last year amid
revelations of lavish spending at a Las Vegas conference."
Something called the Merit Systems Protection Board, the Post
reported, had "ruled the agency failed to prove that the career
civil servant in charge of federal buildings in the Rocky
Mountain region was guilty of misconduct."
The official, Paul Prouty, was awarded eleven months' back
pay and returned to his job as head of federal buildings in the
agency's Rocky Mountain region.
As the Post reminded it readers, "The $823,000 conference
became an embarrassment for the Obama administration after GSA
Inspector General Brian Miller last April on a
four-day junket that had spun out of control. Lodging at an
opulent hotel, entertainment by a $3,200 mind reader,
after-hours parties in 2,400-square-foot loft suites, a $7,000
sushi reception, a bicycle-building exercise - all took place at
taxpayers' expense. The planning included about six scouting
trips, at a tab of $130,000."
According to the Post, "dozens of employees from Prouty's
staff in Region 8 attended the conference." But his lawyer told
the Post that although Prouty "engaged in some of the planning,
GSA was unable to provide any evidence of misconduct."
"At least two other fired senior executives are awaiting
rulings from the merit board on similar appeals," the Post
So here's an obvious follow-up: What does it take to fire a
senior civil servant? Can incompetence ever be good enough, or
must there be proof of misconduct, which has more to do with
motive than performance? And is anyone in Congress or elsewhere
pushing for a change in these budget-challenged times? (Then
again, it would seem odd for anyone in Congress to want simple
incompetence to be a trigger for losing a job.)
I bet a good reporter with a knack for conveying the absurd
would have a field day attending a few Merit Systems Protection
(Steven Brill, the author of Class Warfare: Inside the Fight
To Fix America's Schools, has written for magazines including
New York, The New Yorker, Time, Harpers, and The New York Times
Magazine. He founded and ran Court TV, The American Lawyer
Magazine, ten regional legal newspapers, and Brill's Content
Magazine. He also teaches journalism at Yale, where he founded
the Yale Journalism Initiative. His latest published work is
"Bitter Pill," a special report in the March 4 issue of TIME on