Paperback: 528 pages
Publisher: Random House Trade Paperbacks; 1 edition (August 18, 2015)
Language: English
ISBN-10: 0812986687
ISBN-13: 978-0812986686
Product Dimensions: 5.1 x 1.1 x 8 inches
Shipping Weight: 12.6 ounces (View shipping rates and policies)
Average Customer Review: 4.5 out of 5 stars See all reviews (268 customer reviews)
Best Sellers Rank: #10,226 in Books (See Top 100 in Books) #2 in Books > Law > Health & Medical Law > Medical Law & Legislation #3 in Books > Business & Money > Insurance > Health #6 in Books > Medical Books > Administration & Medicine Economics > Health Policy
AMERICA'S BITTER PILL is an analysis of the US medical care industry, and how Obamacare was implemented. The perspective of the writer is one of a journalist (and sometimes a patient.) That is, this is not a political issue for him--he doesn't take sides, other than recognizing that health care costs are heading our country for a disaster.The author highlights one big advantage of Obamacare, in that so many more people have insurance than did before: "Basically what Obamacare did was a very good thing. It gave tens of millions more people in this country the opportunity to have health care. And it's a longtime national disgrace that we're the only developed country where tens of millions of our citizens can't get health care..."However, here's the bad news. This expansion in coverage came via expanding the Medicaid program; now, "Taxpayers are paying for tens of millions of new customers to pay the same exorbitant prices and fees that everybody else has been paying." So, while it's great that more people are covered--it's at an unsustainable rate: "We cannot continue to be a country where health care prices are 40, 50, 60 percent higher than they are in every other country where the health care results are as good, or better, than ours. It's unsustainable."On prescription drug prices, the author exposes a "secret," which isn't really much of a secret anymore: "The exact same prescription drug in the United States is typically 40 or 50 percent less in Canada, in the United Kingdom, in France, in Germany and Australia -- in every other country in the world because every other country in the world controls the price of monopoly drugs...
This book contains several parts. In part, it is a detailed account of how our dysfunctional political system struggled to put together the Affordable Care Act (ACA) with the “help” of the healthcare industry and its lobbyists. It is in part a detailed account of how the launch of the ACA website was botched by a failure in project management. It is in part the story of how a small group of smart people rescued the website with remarkable speed. It is in part a series of vignettes of the experiences of individual healthcare patients (including the author). It is in part the author’s idea of how our present healthcare system might be adjusted to reduce costs. Finally, the book identifies some of the major cost drivers of our present system.Unfortunately, these individual parts of the book do not come together as a coherent whole because, while the author’s objection to our present system is its high cost, he has chosen to base his book on the legislation and implementation of the ACA whose primary objective is to tackle problems of access to, and denial from, healthcare. While the ACA does also attempt to reduce costs (so far with some success), the root causes of our high cost system will require a much more radical change than is politically feasible at this time. It is a mischaracterization to describe the battle over the ACA as a “Fight to fix our broken healthcare system”; the ACA was only intended to repair some of its most egregious deficiencies. Consequently, the 75% of the book that deals with the ACA is not relevant to Mr. Brill’s well justified concerns over cost: Thus, the core of the book is disconnected from the beginning, the end, and the title.The core of the book, a blow-by-blow account of the development and implementation of the ACA is based on Mr.
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