In other words, everyone along the supply chain — from hospital administrators (who enjoy multimillion-dollar salaries) to the salesmen, executives, and shareholders of drug and equipment makers — was reaping a bonanza. The only exceptions, I found, were those actually treating the patients — the nurses and doctors (unless the doctors were gaming the system by reaping consulting fees from drug or device makers or setting up diagnostic clinics in their practices in order to steer patients there for expensive tests).

It really mattered that I was so curious about all this, and that I became almost obsessively curious as I began to discover what was behind these bills. For there was a mountain of grunt work involved in following the money line by line, from the patient, to the doctor’s office or the clinic or the hospital, and then back to supplier.

That brings to mind another lesson I push on my students, which, because they are a bunch of smart Yalies, sometimes rubs them the wrong way: In journalism, hard work is a lot more important than a high IQ.


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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, Harper's, 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.