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It's a fly-on-the-wall account of the fight, amid an onslaught of lobbying, to pass a 961-page law aimed at fixing America's largest, most dysfunctional industry - an industry larger than the entire economy of France.
It's a penetrating chronicle of how the profiteering that Brill first identified in his Time cover story continues, despite Obamacare.
And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation.
Brill questions all the participants in the drama, including the president, to find out what happened and why.
He asks the head of the agency in charge of the Obamacare website how and why it crashed.
And he tells the cliffhanger story of the tech wizards who swooped in to rebuild it.
Brill gets drug lobbyists to open up on the deals they struck to protect their profits in return for supporting the law.
And he buttresses all these accounts with meticulous research and access to internal memos, emails, notes, and journals written by the key players during all the pivotal moments.
Brill is there with patients when they are denied cancer care at a hospital, or charged $77 for a box of gauze pads. Then he asks the multimillion-dollar executives who run the hospitals to explain why.
Customer ReviewsMost Helpful
By Amazon Customer on 05-14-15
Good facts but sometimes one sided conclusions
It had some good information although not particularly revelatory if you were at all politically aware during the implementation of the ACA. Personally I feel the author did every sort of logical (or non-logical) mental gymnastics to come to the conclusion that is spite of all of the problems with its passage and implementation, the country is better off because of the ACA , and now all we have to do is pass more regulations through, for example, the FTC so that we really fix health care for good. I tried to keep an open mind during this story but still come to the opposite conclusion. In spite of the authors attempt to convince me otherwise, I think the ACA is and will make America worse off in the long run. Regardless of my opinion about the ACA,
the book itself was decent.
8 of 8 people found this review helpful
By DaWoolf on 03-02-15
The agony and ecstasy of Obamacare
Steven Brill provides a critical analysis of the development and implementation of the Affordable Care Act (ACA). Brill starts with the 2008 Democratic Primary, where Barak Obama seemed underprepared to provide a substitutive healthcare plan compared to Hillary Clinton. Recognizing his short-comings, Obama launches himself into the issue that will serve to define his legacy. Brill provides the details on the political deals, players, compromises, and negotiations that allowed the ACA to become law.
Brill does an expert job to describing the ACA registration rollout fiasco and the herculean efforts needed to create a functional enrollment website under immense political pressure. There are also numerous stories of ordinary people with significant health conditions and how they were affected by the ACA.
The problem with America’s Bitter Pill (ABP) is the big take away, although universal health coverage is terrific the ACA lacks the regulations to contain consumer costs. This issue is due to the fact that the ACA was written to protect the financial interests of insurance providers, hospitals, pharmaceutical companies and medical equipment suppliers. ABP reminded me of Otto von Bismarck’s famously stated quote “Laws are like sausages, it is better not to see them being made.”
6 of 6 people found this review helpful