Money, Politics, Back-Room Deals, and the Fight to Fix Our Broken Healthcare System
On Sale: January 5, 2015
Hardcover / e-Book
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America’s Bitter Pill is Steven Brill’s much-anticipated,
sweeping narrative of how the Affordable Care Act, or
Obamacare, was written, how it is being implemented, and,
most important, how it is changing—and failing to change—the
rampant abuses in the healthcare industry. Brill probed the
depths of our nation’s healthcare crisis in his trailblazing
Time magazine Special Report, which won the 2014 National
Magazine Award for Public Interest. Now he broadens his lens
and delves deeper, pulling no punches and taking no prisoners.
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,
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
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
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.
He even confronts the chief executive of America’s largest
health insurance company and asks him to explain an
incomprehensible Explanation of Benefits his company sent to
And he’s there as a group of young entrepreneurs gamble
millions to use Obamacare to start a hip insurance company
in New York’s Silicon Alley.
Vividly capturing what he calls the “milestone” achievement
of Obamacare, Brill introduces us to patients whose bank
accounts or lives have been saved by the new law—although,
as he explains, that is only because Obamacare provides
government subsidies for “tens of millions of new customers”
to pay the same exorbitant prices that were the problem in
the first place.
All that is weaved together in an elegantly crafted,
But by chance America’s Bitter Pill ends up being much
more—because as Brill was completing this book, he had to
undergo urgent open-heart surgery.
Thus, this also becomes the story of how one patient who
thinks he knows everything about healthcare “policy”
rethinks it from a hospital gurney—and combines that insight
with his brilliant reporting.
The result: a surprising new vision of how we can fix
American healthcare so that it stops draining the bank
accounts of our families and our businesses, and the federal
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