America's Bitter Pill by Steven Brill

America's Bitter Pill

For readers of Double Down and This Town comes a fraught and fascinating fly-on-the-wall account of the Affordable Care Act (“Obamacare”), the most significant piece of legislation of our time, from its inception to its implementation and beyond. Written by the author of the National Magazine Award–winning Time magazine article “Bitter Pill,” this epic political drama provides an unprecedented look at the broken U.S. healthcare system, ...

Details America's Bitter Pill

TitleAmerica's Bitter Pill
Release DateJan 5th, 2015
PublisherRandom House
GenrePolitics, Nonfiction, Health, Health Care, Medicine, History

Reviews America's Bitter Pill

  • Margitte
    The question is: What time is it?The possible answers:"It's late" - politicians and academics."It's exactly nine thirty am" - scientists and economists.This is how the question of an Affordable Care Act for all citizens were addressed by the different role players, and with the democratic process applied to it, got answered. All stakeholders claimed part of a victory that never happened. Nobody is smiling.In came Brill on the Bill. This book, yes...
  • Gilda Felt
    Reading this book, I was almost inclined to think “a plague on both your houses,” except at least with the Democrats it comes down to what they didn’t do, like push for a public option, and failing to deal with the staff incompetence and turf wars inside the White House that were the major reasons for the ACA website crash.It’s a different story on the other side. Over fifty attempts at overriding the bill, but with no solution of their o...
  • Richard Nelson
    If you have been paying attention the last six years there's little to surprise you in this thoroughly reported novelization of the horror movie that has been our national health care reform debate and implementation. Still, Brill does a good job of keeping track of the myriad compromises that were made along the way in order to pass the bill and placate the opposition after its passage (albeit mostly unsuccessfully--nothing seems to slake the th...
  • Dave
    Steven Brill has written a well balanced, clear-eyed account of the tortured passage of the Affordable Care Act (ACA). No one involved, including President Obama receives a grade of 'A' in this saga. Brill's account is clear, detailed, well-researched, and exhaustive. Although reading this can get slightly tedious at times, I believe Brill was spot-on in providing the detail he did. It gives the reader a good feel for how and why the law wound up...
  • Bobbi
    There were moments in the long discourse on how the launch of Obamacare got bungled when my patience grew thin, because I'd followed this all at the time. But then Brill would come through with some inside story that I hadn't heard, and I would be fascinated. Here you can read about the incompetency and turf wars among top-level mismanagement handling the ADA roll out, the maneuverings of special interests and on occasion, revisit the pain of the...
  • Book
    America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System by Steven Brill“America's Bitter Pill” is a comprehensive story of how Obamacare happened, what it means, what it will fix, and what it won’t fix. American lawyer and journalist-entrepreneur, Steven Brill takes the reader on a journey of how the Affordable Care Act (ACA) took place. This far-reaching 530-page book includes twenty-three ...
  • Don
    I know not everyone will have the time to read this book, so I will share what I learned because I think it is important for more people to know this.Time Magazine's Steven Brill takes on a big project in telling the story of how our modern health care system and particularly Obamacare came to be and what has happened since then. Reading this book was like watching an impending train wreck in slow motion. The reader knows it is not going to end w...
  • John
    Healthcare coverage has never been something I’ve paid a whole lot of attention to. Why? Because for my entire life I’ve been covered by an employer Healthcare Plan, one of which was a “Cadillac” plan. However, now that I’m in the Medicare system, and my spouse is in a non-Cadillac retiree employer plan, I’m paying more attention to healthcare. All it takes is paying twice as much or more as last year to get my attention. This book is...
  • srdjan
    An impressive overview of the key components of the healthcare system as well as an illuminating view on the legislative process. The breadth of topics covered (in what seems like a generally sound way) is remarkable. But the most lasting impression i had from this book was how it highlighted a "unknown known" for the author's generation. "No amount of savings is worth a 10% discount on your life". What if those savings meant your family could st...
  • Monica Willyard
    This book goes beyond political parties to discuss the failures and successes of the new healthcare system. It gave me a lot to think about, and I'm a little less against the healthcare act than I was before reading this book. However, I am concerned that costs are spiraling out of control, and i'm still concerned that we can't pay for this act. Medicare is broken, and I think it will go bankrupt soon. At least, this book showed me clearly where ...
  • Coleman
    We’ve swallowed a bitter pill indeed, considering how divisive, controversial, and in many ways, utterly ineffective the Affordable Care Act is. Steven Brill leaves no stone unturned in his balanced investigation of the bill’s history, passage, and implementation over 6 or 7 years in Washington D.C. This makes the book a bit of a slog with its meticulous recordings of email correspondances and meetings, and its cast of thousands of congressme...
  • Ray
    Steven Brill's book "America's Bitter Pill", won't help anyone with purchasing health insurance on State or Federal exchanges, and won't answer any specific questions on medical health coverage, costs, or options, but it does provide an interesting look into the development, changes, compromises, flaws and benefits of our Nations new complex and controversial health care law known as ObamaCare. With a law this massive, impacting so many people an...
  • Al
    Having read Steve Brill's long and eye-opening article on health care costs in Time magazine, I was eager to read his new book on ObamaCare. It was disappointing. Brill describes the tortuous and discouraging path of the ObamaCare legislation through Congress. We know most of the main facts, but Brill adds details and provides an overview of the major initiatives included in the bill. He then moves to a description of the totally bungled implemen...
  • David Quinn
    I respect and appreciate the author’s thoroughness and attention to detail but, as a book I was reading for pleasure, I think the final product would have been better off if much of the political wrangling and policy details had been moved to an Appendix. In the several cases where the details started to get too thick Brill could have offered a general insight and referenced the particulars elsewhere. Had he done that I would have rated this 5 ...
  • Bm
    Being a European who knows nothing about American healthcare, I thought this book was absolutely fantastic. Incredibly thorough, clear-sighted and ultimately damming, Brill's overview of the genesis through to completion of the ACA is a worthy introduction to this tangled briar of a topic. Yet, for me, it worked best as an education in the realpolitik of the American political process. I thought back to Biden staffer and ex-lobbyist Jeff Conaught...
  • Sean McKenna
    How much you like this book will depend on how interested you are in the blow-by-blow details of how the ACA got passed and implemented. While it contains a good explanation of the healthcare ecosystem in the US and why reform is so difficult, it is dominated by the strictly chronological, often tedious account of the political machinations required to get the law passed and then the bureaucratic challenges involved in putting it into practice. B...
  • Marillyn Kelemen
    This book was highly informative. A must read for everybody struggling with issues of healthcare. At times it made me very angry, frustrated and embarrassed for the lack of knowledge by most Americans (me included). It also made me feel hopeless and helpless. All the power sits in Washington and with the pharmaceutical lobby. It all seems to be about money: who can get the most at the expense of others. It appears to be a game and the American pu...
  • Andrea
    Everyone should read this book. It's truly eye opening to see how the government operates and how the Health Industry operates in the United States.
  • Michael
    Excellent reporting and analysis of Obamacare's enactment (how it got passed) and implementation (how the exchange website was initially botched, because no one person owned the final result). For Brill, it all starts with two World-War-II-era agency rulings (a) that health insurance was not subject to the wage controls, and (b) that it therefore was not taxable income. These rulings led to our current system of employer-provided healthcare, whic...
  • Justin Tapp
    Brill is a writer for TIME and wrote the seminal article on the Affordable Care Act, consuming an entire issue of the magazine, in 2014. This book was largely a result of his research for that article and his own experience, being hospitalized with a heart aneurysm and experiencing the "broken" health care system first-hand. Brill was given access to many in the White House, including President Obama, who wanted his "voice" to be part of the book...
  • Mack Hayden
    I had a love/hate relationship with this book. On the one hand, Brill does an absolutely excellent job of conveying the good, the bad and the ugly facts about Obamacare and its stormy history. Given how it may wind up on history's ash heap with the Trump Administration, this book may well serve as one of the better manuscripts documenting the conception and final days of a flawed but beneficial set of health care reforms. No one gets out of this ...
  • Mauricio Maluff Masi
    This book was excellent as a journalistic account of how the ACA became law, of the political challenges of passing the bill, and of creating (and fixing) I learned more about how a big bill becomes law from this than from any other source before, and it's worth reading just for that. The biggest flaws of the narrative are that Brill is simultaneously too cynical and not cynical enough: he gives too much benefit of the doubt to st...
  • Heather in FL
    This is another book that may have been better for me in print or digital form instead of audio, so I could flip back to pages to review or clarify information. The book was chock full of information about how the ACA came to be, the deals that had to be made to push it through, the finagling in the legislative branch. Anecdotes from some of the people involved. I've always though the ACA was a good place to start. I'm not a fan of repealing it a...
  • erica
    Well written and comprehensive, full of facts, figures, and statistics. Anyone interested in understanding the issues surrounding the current healthcare debates and legislation should pick up a copy of America's Bitter Pill. Brill does a fantastic job of explaining the compromises made in order to expand healthcare coverage. Overall, a very informative read that acts as a great primer on the "problem" of healthcare in America today.
  • Vishakha Bhedasgaonkar
    Through this political narrative of Obamacare and how it affected the healthcare delivery system, Brill gives the readers a fascinating account of market structure, government organization and bureaucracy, both optimistic and pessimistic, but insightful and interesting.
  • Kurt
    A statistic that I often refer to is that, despite spending more than double what every other developed nation spends on healthcare (both as a percent of GDP and as a percent of average income), the U.S. still manages to have worse health and worse health care than all of them and our system fails to provide basic healthcare coverage for a huge percentage of its citizens, mostly those who are most in need of it, while every other developed nation...
  • Brian Gordon
    This book is Steven Brill's much ballyhooed look at the passage of Obamacare. The book was an interesting look into the passage of the bill and the back alley deals made to get its passage. It also does a good job of exposing the huge profits made by hospitals, pharmaceutical companies, and medical device manufacturers. There are two massive flaws with the book. It expertly shows how the government completely flubbed the building, testing, and im...
  • Summer
    I was deeply interested in this book. Hearing about all the backroom deals was kind of like watching a train wreck. To me, this subject is fascinating because I'm conflicted at almost every angle. I really do think healthcare is a human right but I also think people should take care of themselves. I know profits incentivize innovation but I'm also horrified at drug companies charging literally $1K a pill for things that people have virtually no c...
  • David
    The Patient Protection and Affordable Care Act will probably go down as President Obama's greatest achievement. This book is a perfect day by day account as to how that law became what it was, and how it was passed. It is eye opening. The special interests and "back room" deals that went on, shows us how Washington works. Brill also goes over when the exchanges opened and the website that just wouldn't work, and the constant republican opposition...
  • Fred Forbes
    I often wondered why the conservative right wing attacks the Affordable Healthcare Act (Obamacare) with such ferocity. After all, it protects those with vested interests and expensive lobbyists - keeps the insurance companies in the mix by steering away from the "single payer" idea that much of the world uses so efficiently, bars the government from bargaining with the pharmaceutical companies (so we end up with drug price 50% higher than the res...