America"s Bitter Pill

America’s Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System Hardcover – January 5, 2015

Author: Steven Brill | Language: English | ISBN: 081299695X | Format: PDF, EPUB

America’s Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System – January 5, 2015
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• Hardcover: 528 pages


• Publisher: Random House (January 5, 2015)


• Language: English


• ISBN-10: 081299695X


• ISBN-13: 978-0812996951


• Product Dimensions: 6.4 x 1.3 x 9.5 inches


• Shipping Weight: 1.8 pounds (View shipping rates and policies)


• Amazon Best Sellers Rank: #22 in Books (See Top 100 in Books)
  
  • #1 in Books > medical books > administration & Medicine Economics > Health Care Delivery
  
  
  • #1 in Books > law > health & Medical Law > Medical Law & Legislation
  
  
  • #1 in Books > Politics & Social Sciences > Politics & Government > United States > National
  
  

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…

Americans spent an estimated $3 trillion on healthcare in 2014 – about 18% of GDP, more than any other developed nation, with average lifespans ranking only #31 in the world. On artificial knees and hips alone, we spent about 55% more than Hollywood took in at the box office. Also $85.9 billion on back pain – more than state, county, and city/town police forces, and of which experts contend as much as half is useful. Medtronic, maker of a variety of medical devices, charges such high prices that its gross profit margins nearly double that of Apple.

Author Brill is outraged by these high costs (still – after his 2013 Times article), as we all should be. Most of the book is taken up with detailing how the Affordable Care Act (ACA, alias ‘ObamaCare) came about. Per a credible consultant, the Obama health-plan formulators were convinced to pursue extending coverage to all rather than reducing costs. The reason – he/they saw the latter as going nowhere due to the strength of industry lobbyists. (Healthcare spends 4X the #2 group of lobbyists, our feared military-industrial complex.) HillaryCare and Massachusetts had also taken the same path, undoubtedly for the same reason. However, spending most of the book on detailing the personalities involved and how the long, detailed, overly complex ACA came about was not a good use of Brill’s time/talent, nor that of readers either..

The Obama team should have at least marched into legislative negotiations with a well-thought-out plan. However, they didn’t, and thereby became sitting ducks for industry lobbyists. Thus, the ACA failed to even achieve its main goal of universal coverage, and disappointed Brill (and myself) on directly reducing costs.

America’s Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System – January 5, 2015 Download

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