America's Bitter Pill
Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System
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Narrated by:
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Dan Woren
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By:
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Steven Brill
About this listen
NEW YORK TIMES BESTSELLER • A NEW YORK TIMES NOTABLE BOOK • “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times
America’s Bitter Pill is Steven Brill’s acclaimed book on 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. It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine 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.
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 treasury.
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“An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Steven Brill] has pulled off something extraordinary—a thriller about market structure, government organization and billing practices.”—The New York Times Book Review
“A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system’ . . . For its insights into our nation’s fiscal, psychological and corporeal health—and for our own long-term social well-being—it is a book that deserves to be read and discussed widely by anyone interested in the politics and policy of healthcare.”—Los Angeles Times
“A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform . . . [Brill’s] book brims with unconventional insight delivered in prose completely uninfected by the worn out tropes and tired lingo of the Sunday shows.”—The Daily Beast
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Barack Obama’s inauguration as president on January 20, 2009, inspired the world. But the great promise of “Change We Can Believe In” was immediately tested by the threat of another Great Depression, a worsening war in Afghanistan, and an entrenched and deeply partisan system of business as usual in Washington. Despite all the coverage, the backstory of Obama’s historic first year in office has until now remained a mystery.
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Tiresome
- By Matthew on 05-21-10
By: Jonathan Alter
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Confidence Men
- Wall Street, Washington, and the Education of a President
- By: Ron Suskind
- Narrated by: James Lurie
- Length: 22 hrs
- Unabridged
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The hidden history of Wall Street and the White House comes down to a single American concept: confidence. Both centers of power, New York and Washington, learned how to manufacture it - until August 2007, when that confidence began to crumble. Ron Suskind here tells the story of what happened next, as Wall Street struggled to save itself while a man with little experience and soaring rhetoric emerged from obscurity to usher in "a new era of responsibility".
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Insightful, but...
- By Ray on 10-29-11
By: Ron Suskind
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Hostile Takeover
- Resisting Centralized Government's Stranglehold on America
- By: Matt Kibbe
- Narrated by: George Newbern
- Length: 12 hrs and 11 mins
- Unabridged
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Hostile Takeover is a rebellious challenge to the "upper management" of government, who are choking American prosperity and liberty. Matt Kibbe exposes the privileged collusion of Washington insiders - and maps out a proven plan for how to return power from the self-appointed "experts" back to the people. Dubbed "one of the Tea Party's masterminds" by Newsweek, Kibbe reveals how grassroots citizens can and will check the federal behemoth and restore the American enterprise.
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An amazing book from an interesting perspective
- By Aaron on 12-28-12
By: Matt Kibbe
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Reinventing American Health Care
- How the Affordable Care Act Will Improve Our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System
- By: Ezekiel J. Emanuel
- Narrated by: William Dufris
- Length: 11 hrs and 57 mins
- Unabridged
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Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania who also served as a special adviser to the White House on health-care reform, has written a brilliant diagnostic explanation of why health care in America has become such a divisive social issue, how money and medicine have their own American story, and why reform has bedeviled presidents of the left and right for more than one hundred years.
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The book lacks integrity
- By Richard M. Shaner on 06-02-16
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Get What's Yours for Medicare
- Maximize Your Coverage, Minimize Your Costs
- By: Philip Moeller
- Narrated by: James Foster
- Length: 7 hrs and 27 mins
- Unabridged
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A coauthor of the New York Times bestselling guide to Social Security Get What's Yours authors an essential companion to explain Medicare, the nation's other major benefit for older Americans. Learn how to maximize your health coverage and save money.
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Very Negative and Overwhelming
- By A.C.W. on 04-08-20
By: Philip Moeller
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Armageddon
- How Trump Can Beat Hillary
- By: Dick Morris, Eileen McGann
- Narrated by: Ian Patterson
- Length: 8 hrs and 45 mins
- Unabridged
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Timed for the critical presidential election season, New York Times best-selling author and noted political commentator Dick Morris provides a strategy and position on the issues for Republicans to attract crucial new voters to the party in order to win back the White House in 2016 and put an end to the Obama agenda of ruinous socialism. By using new issues, attracting new voters, and offering new alternatives, Republicans can win the election of 2016 and save America!
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Informative and practical a must read
- By quentin on 06-30-16
By: Dick Morris, and others
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Class Warfare
- Inside the Fight to Fix America's Schools
- By: Steven Brill
- Narrated by: L. J. Ganser
- Length: 16 hrs
- Unabridged
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Performance
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In a reporting tour de force, award-winning journalist Steven Brill takes an uncompromising look at the adults who are fighting over America’s failure to educate its children and points the way to reversing that failure. Brill not only takes us inside their roller-coaster battles, he also concludes with a surprising prescription for what it will take from both sides to put the American dream back in America’s schools.
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Unions are Evil
- By Elton on 09-16-11
By: Steven Brill
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Nothing to Fear
- FDR's Inner Circle and the Hundred Days That Created Modern America
- By: Adam Cohen
- Narrated by: Norman Dietz
- Length: 14 hrs and 10 mins
- Unabridged
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Overall
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Nothing to Fear brings to life a fulcrum moment in American history - the tense, feverish first 100 days of Franklin Delano Roosevelt's presidency, when he and his inner circle completely reinvented the role of the federal government.
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Important contribution
- By R.S. on 03-05-09
By: Adam Cohen
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Detroit Resurrected
- To Bankruptcy and Back
- By: Nathan Bomey
- Narrated by: Jonathan Yen
- Length: 9 hrs and 31 mins
- Unabridged
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Overall
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Performance
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From thriving Motor City to the largest municipal bankruptcy in American history, Detroit has become the nation's cautionary tale. But what led to the fateful day of the filing, and how did the city survive this crisis? Journalist Nathan Bomey delivers the inside story of Detroit's decline and the people who fought to save it against impossible odds: Governor Rick Snyder, a self-proclaimed nerd; emergency manager Kevyn Orr, a lawyer with singular dedication; Judge Steven Rhodes, the city's conscience; and retirees who fought to ensure that Detroit kept its promises.
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Outsiders Perspective
- By Carl on 02-07-17
By: Nathan Bomey
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The Best Worst President
- What the Right Gets Wrong About Barack Obama
- By: Mark Hannah
- Narrated by: Kaleo Griffith
- Length: 7 hrs and 56 mins
- Unabridged
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Political analyst and Democratic campaign veteran Mark Hannah gives Barack Obama the victory lap he deserves in this compendium that takes the president's critics head-on and celebrates the president's many underappreciated triumphs.
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Thought-provoking
- By Jean on 07-11-16
By: Mark Hannah
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Outsider in the White House
- Special Audio Edition
- By: Bernie Sanders, Huck Gutman, John Nichols - afterword
- Narrated by: Joe Barrett, Brian Sutherland
- Length: 10 hrs and 5 mins
- Unabridged
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Overall
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Performance
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Bernie Sanders' campaign for the presidency of the United States has galvanized supporters all over the country, drawing attention to issues of economic, racial, and social justice and spotlighting one of the most interesting and unconventional candidates in decades.
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Behind the Scenes with Bernie--- WORTH it!
- By Susie on 02-23-16
By: Bernie Sanders, and others
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How did we become a world where facts—shared truths—have lost their power to hold us together as a community, as a country, globally? How have we allowed the proliferation of alternative facts, hoaxes, even conspiracy theories, to destroy our trust in institutions, leaders, and legitimate experts? Best-selling journalist Steven Brill documents the forces and people, from Silicon Valley to Moscow to Washington, that have created and exploited this world of chaos and division—and offers practical solutions for what we can do about it.
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It’s all about follow the money with programmatic advertising.
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An American Sickness
- How Healthcare Became Big Business and How You Can Take It Back
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It is well documented that our health-care system has grave problems, but how, in only a matter of decades, did things get this bad? Dr. Elisabeth Rosenthal doesn't just explain the symptoms; she diagnoses and treats the disease itself. Rosenthal spells out in clear and practical terms exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship, explaining step by step the workings of a profession sorely lacking transparency.
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Not well balanced
- By Anonymous User on 02-12-18
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Tailspin
- The People and Forces Behind America's Fifty-Year Fall - and Those Fighting to Reverse It
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In this revelatory narrative covering the years 1967 to 2017, Steven Brill gives us a stunningly cogent picture of the broken system at the heart of our society. He shows us how, over the last half-century, America's core values - meritocracy, innovation, due process, free speech, and even democracy itself - have somehow managed to power its decline into dysfunction.
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Shorter would have been Better
- By Joseph on 06-12-18
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The Price We Pay
- What Broke American Health Care - and How to Fix It
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- Narrated by: Marty Makary MD
- Length: 9 hrs and 29 mins
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One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research and his own experience, The Price We Pay paints a vivid picture of price-gouging, middlemen and a series of elusive money games in need of a serious shake-up.
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Very important book!
- By Wayne on 05-17-21
By: Marty Makary MD
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Sickening
- How Big Pharma Broke American Health Care and How We Can Repair It
- By: John Abramson
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The United States spends an excess $1.5 trillion annually on health care compared to other wealthy countries—yet the amount of time that Americans live in good health ranks a lowly 68th in the world. At the heart of the problem is Big Pharma, which funds most clinical trials and therefore controls the research agenda, withholds the real data from those trials as corporate secrets, and shapes most of the information relied upon by health care professionals.
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Great info, but I’m confused…
- By Iread on 04-04-22
By: John Abramson
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Pharma
- Greed, Lies, and the Poisoning of America
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Pharmaceutical breakthroughs such as antibiotics and vaccines rank among some of the greatest advancements in human history. Yet, exorbitant prices for life-saving drugs, safety recalls affecting tens of millions of Americans, and soaring rates of addiction and overdose on prescription opioids have caused many to lose faith in drug companies. Now, Americans are demanding a national reckoning with a monolithic industry.
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Great book, but with some issues
- By Irina on 06-12-20
By: Gerald Posner
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The Death of Truth
- How Social Media and the Internet Gave Snake Oil Salesmen and Demagogues the Weapons They Needed to Destroy Trust and Polarize the World—and What We Can Do
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How did we become a world where facts—shared truths—have lost their power to hold us together as a community, as a country, globally? How have we allowed the proliferation of alternative facts, hoaxes, even conspiracy theories, to destroy our trust in institutions, leaders, and legitimate experts? Best-selling journalist Steven Brill documents the forces and people, from Silicon Valley to Moscow to Washington, that have created and exploited this world of chaos and division—and offers practical solutions for what we can do about it.
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It’s all about follow the money with programmatic advertising.
- By scott b burton on 11-07-24
By: Steven Brill
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An American Sickness
- How Healthcare Became Big Business and How You Can Take It Back
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It is well documented that our health-care system has grave problems, but how, in only a matter of decades, did things get this bad? Dr. Elisabeth Rosenthal doesn't just explain the symptoms; she diagnoses and treats the disease itself. Rosenthal spells out in clear and practical terms exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship, explaining step by step the workings of a profession sorely lacking transparency.
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Not well balanced
- By Anonymous User on 02-12-18
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Tailspin
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In this revelatory narrative covering the years 1967 to 2017, Steven Brill gives us a stunningly cogent picture of the broken system at the heart of our society. He shows us how, over the last half-century, America's core values - meritocracy, innovation, due process, free speech, and even democracy itself - have somehow managed to power its decline into dysfunction.
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Shorter would have been Better
- By Joseph on 06-12-18
By: Steven Brill
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The Price We Pay
- What Broke American Health Care - and How to Fix It
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- Narrated by: Marty Makary MD
- Length: 9 hrs and 29 mins
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One in five Americans now has medical debt in collections and rising health care costs today threaten every small business in America. Dr Makary, one of the nation's leading health care experts, travels across America and details why health care has become a bubble. Drawing from on-the-ground stories, his research and his own experience, The Price We Pay paints a vivid picture of price-gouging, middlemen and a series of elusive money games in need of a serious shake-up.
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Very important book!
- By Wayne on 05-17-21
By: Marty Makary MD
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Sickening
- How Big Pharma Broke American Health Care and How We Can Repair It
- By: John Abramson
- Narrated by: Kevin Stillwell
- Length: 9 hrs and 17 mins
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The United States spends an excess $1.5 trillion annually on health care compared to other wealthy countries—yet the amount of time that Americans live in good health ranks a lowly 68th in the world. At the heart of the problem is Big Pharma, which funds most clinical trials and therefore controls the research agenda, withholds the real data from those trials as corporate secrets, and shapes most of the information relied upon by health care professionals.
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Great info, but I’m confused…
- By Iread on 04-04-22
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Pharma
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Great book, but with some issues
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Bottle of Lies
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From an award-winning Fortune reporter, an explosive narrative investigation of the generic drug boom that reveals the life-threatening dangers posed by globalization - The Jungle for pharmaceuticals.
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overbearing self-righteous indignation
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How to Make a Killing
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Six decades ago, visionary doctors achieved the impossible: the humble kidney, acknowledged since ancient times to be as essential to life as the heart, became the first human organ to be successfully replaced with a machine. Yet huge dialysis corporations, ambitious doctor-entrepreneurs, and Beltway lobbyists soon turned this medical miracle into an early experiment in for-profit medicine—and one of the nation's worst healthcare catastrophes.
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NME - The McDonald’izing of healthcare
- By Jillian Astra England on 04-30-24
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Reframing Healthcare: A Roadmap for Creating Disruptive Change
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Dr. Zeev Neuwirth wrote Reframing Healthcare for leaders and organizations interested in understanding what the disrupters in healthcare are doing and, more to the point, for those who want to be the disrupters rather than the disrupted. This audiobook is a step-by-step guide for leadership teams that are intent on improving healthcare at an accelerated pace. It’s written for healthcare organizations that wish to thrive in a customer-centric, community-oriented, value-based healthcare system.
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Great content and resources
- By Galen on 07-12-19
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Never Pay the First Bill
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Every year, millions of Americans are overcharged and underserved while the health-care industry makes record profits. We know something is wrong, but the layers of bureaucracy designed to discourage complaints make pushing back seem impossible. Never Pay the First Bill is the guerilla guide to health care the American people and employers need. Drawing on 15 years of investigating the health-care industry, reporter Marshall Allen shows how companies and individuals have managed to force medical providers to play fair and shows how you can, too.
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Comprehensive Guide To Not Getting F***d by Bills
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By: Marshall Allen
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Unaccountable
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Dr. Marty Makary is co-developer of the life-saving checklist outlined in Atul Gawande's best-selling The Checklist Manifesto. As a busy surgeon who has worked in many of the best hospitals in the nation, he can testify to the amazing power of modern medicine to cure. But he's also been a witness to a medical culture that routinely leaves surgical sponges inside patients, amputates the wrong limbs, and overdoses children because of sloppy handwriting. Over the last 10 years, neither error rates nor costs have come down, despite scientific progress.
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Everyone should read this book.
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By: Marty Makary
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An Elegant Defense
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A magnificently reported and soulfully crafted exploration of the human immune system - the key to health and wellness, life and death. An epic, first-of-its-kind audiobook, entwining leading-edge scientific discovery with the intimate stories of four individual lives, by the Pulitzer Prize-winning New York Times journalist.
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Weak foundation, good conclusion
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By: Matt Richtel
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The Social Transformation of American Medicine
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Considered the definitive history of the American healthcare system, The Social Transformation of American Medicine examines how the roles of doctors, hospitals, health plans, and government programs have evolved over the last two and a half centuries. Updated with a new preface and an epilogue analyzing developments since the early 1980s, this new edition is a must-listen for anyone concerned about the future of our fraught healthcare system.
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Fascinating Survey of Healthcare in Amerixa
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Deep Medicine
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Medicine has become inhuman, to disastrous effect. The doctor-patient relationship - the heart of medicine - is broken: doctors are too distracted and overwhelmed to truly connect with their patients, and medical errors and misdiagnoses abound. In Deep Medicine, leading physician Eric Topol reveals how artificial intelligence can help. AI has the potential to transform everything doctors do, from notetaking and medical scans to diagnosis and treatment, greatly cutting down the cost of medicine and reducing human mortality.
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a must book for all doctors and patients.
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By: Eric Topol
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Under the Skin
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From an award-winning writer at the New York Times Magazine and a contributor to the 1619 Project comes a landmark book that tells the full story of racial health disparities in America, revealing the toll racism takes on individuals and the health of our nation.
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Personal stories
- By Aiman Tulaimat on 12-15-23
By: Linda Villarosa
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The Hidden History of the Supreme Court and the Betrayal of America
- The Thom Hartmann Hidden History Series
- By: Thom Hartmann
- Narrated by: Sean Pratt
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- Unabridged
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Overall
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Performance
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Story
Taking his typically in-depth, historically informed view, Thom Hartmann asks: What if the Supreme Court didn't have the power to strike down laws? According to the Constitution, it doesn't. From the founding of the republic until 1803, the Supreme Court was the final court of appeals, as it was always meant to be. So where did the concept of judicial review start? As so much of modern American history, it began with the battle between the Federalists and Anti-Federalists, and with Marbury v. Madison.
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A must read to understand why voting is essential.
- By Brandon WIlliams on 10-05-19
By: Thom Hartmann
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Lies I Taught in Medical School
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- By: Robert Lufkin MD
- Narrated by: Jim Meskimen
- Length: 8 hrs and 6 mins
- Unabridged
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Overall
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For the first time in history, chronic diseases like diabetes, hypertension, and obesity plague our population on a global scale. From a seasoned physician, this paradigm-shifting book comprehensively explains the linked cause of chronic diseases and exposes the misconceptions prevalent in modern medicine. In Lies I Taught in Medical School, Robert Lufkin, MD, explains that metabolic dysfunction is the common underlying cause of most chronic diseases that has been overlooked for decades, providing the tools needed to prevent and reverse them in ourselves.
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Bold new perspectives
- By Shad on 07-10-24
By: Robert Lufkin MD
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The Longest Con
- How Grifters, Swindlers, and Frauds Hijacked American Conservatism
- By: Joe Conason
- Narrated by: Steve Marvel
- Length: 10 hrs and 55 mins
- Unabridged
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The Longest Con tells the fascinating story of the partisan con artists who have corrupted conservative politics in our time, creating a toxic phenomenon that culminated in the election of Donald Trump, a bumptious fraud whose checkered career and tawdry retinue, including his presidential cabinet, have featured almost every variety of scam. But long before he appeared, Trump's path to power was blazed by the motley horde of swindlers and quacks who preceded him.
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Very interesting wide lens view
- By CG on 09-17-24
By: Joe Conason
What listeners say about America's Bitter Pill
Average customer ratingsReviews - Please select the tabs below to change the source of reviews.
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- James
- 02-13-15
Best Non-Fiction since Game Change
I read on average two books each week. Steven's brilliant style, clever approach and direct questioning is the heart of a book that should be part of the curriculum in high school civics/social studies classes. Truly enthralled with this work. Don't miss this because it effects everyone going forward for decades to come.
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5 people found this helpful
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- KEVIN PARKE
- 04-11-16
Messed up Health Care System
I liked the story, although I'm not sure I agree with the author's proposed solutions, but found it frustrating that our system is so messed up.
Well researched
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- Roger P Carvalho
- 06-24-19
History on why US healthcare sucks
Very good and very interesting- overwhelming detail on why politics is the plague of government
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- VerdereC
- 06-10-17
Great initial read on Healthcare problems
Provided overview and insights into current situation and the political aspects that need to be addressed
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- Amazon Customer
- 12-12-18
So informative
This book ought to be required reading to be a US citizen (and registered voter)...
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- Beth Brand
- 03-29-15
Everyone should read this
I don't even want to talk with you about healthcare reform in American unless you have read this book.
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- Brian
- 09-29-15
informative and well read
filled with great facts. presented in highly entertaining form. highly recommend for anyone trying to understand the ACA.
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- Ter
- 06-21-22
Why health care in the United States doesn’t work.
This well written and extensively researched book shines a bright light on the extent of the GREED in our prescription drug prices in this country. A massive redistribution of wealth and the reinforcement of the have’s verses the have nots is in very clear focus.
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- Joseph
- 02-28-15
Must read/listen
As a generalist physician who has spent the last 35 years inside the system, the exposure of the true guts of the system, was elucidating and disquieting. For administrators of this system to be paid so much more than those who actually deliver the care is disquieting too. Incentives are displaced badly.
I do not know if Brill's suggestions at the end of the book would work, but they would allow true market forces to work on efficiency and competence.
I finished the book enlightened and discouraged about the future of my profession.
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14 people found this helpful
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- Kate M.
- 05-24-15
An Important Book for Everyone
Would you listen to America's Bitter Pill again? Why?
No--I do not listen to books more than once. I have too many that I still need to get to!
What was one of the most memorable moments of America's Bitter Pill?
There were so many unbelievable scenarios and anecdotes in this book that I found myself constantly amazed by what I did not know until I listened to the book. One that stands out is a man who had pneumonia and was hit with a $143,000 lab bill from the hospital for which he was personally responsible. Or the previously uninsured woman who had significant health issues but could not afford her medication. The author suggested that she look into her state's new insurance exchange and she said that she would never get "Obamacare" because her political representatives said that it was bad and would not cover current illness. She did get insurance through her state exchange (she did not realize that it was possible because it was "Obamacare") and then got her heart disease and diabetes under control.
Which character – as performed by Dan Woren – was your favorite?
Steve Beshear, the governor of Kentucky, got on the band wagon early and set up Kynect, KY's health exchange. KY is one of the worst states for health outcomes and issues. This exchange was created under budget, on time, and was working when the federal exchanges did not.
I also enjoyed that Mitch McConnell, the representative from KY, finally said he liked Kynect but not Obamacare--not explaining to his constituents that they are the same thing!
Did you have an extreme reaction to this book? Did it make you laugh or cry?
This is a brilliant book which caused me to experience many emotions--mostly frustration and incredulity, and a few laughs at the craziness of the political struggles. The absolute vitriol leveled by all sides of the debate (there were many sides) was so disgusting that I had to laugh.
Any additional comments?
In addition to understanding the difficult birth and life of the Affordable Care Act, I found that I learned even more about the medical and insurance industries pre-Act. I have always had good insurance so never really paid attention to what was going on behind the scenes. Brill has done an outstanding job in making this complex issue understandable and interesting.
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