Now we go to the sausage factory to see how Obamacare was crafted..Brill’s new book, America’s Bitter Pill, his fresh, outsider curiosity makes him a superb guide to the maze of issues in American health care and health care reform. He breaks down insider language, asks fundamental and surprising questions, and leaves the reader — at least this one — full of more questions yet with a much clearer map of the lines of debate. You may not be persuaded by his conclusions, but you’ll emerge with a broader understanding of the characters and questions shaping our health care system...an energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy. It is full of insights, contradictions, apologias, flashes of anger, tidbits of history, extended stories of awe, compassion, some glibness and moments of brilliance. Above all, it includes fascinating reporting on how crucial decisions were made involving the drafting and implementation of the Affordable Care Act...about a Washington fight for power among five key forces: insurers, hospitals, patients, pharmaceutical companies and medical equipment suppliers, and the general public, including those who are supposed to represent them. In Brill’s account of the Affordable Care Act, the insurers got a fair shake, uninsured and underinsured patients truly benefited, hospitals and pharmaceutical companies and medical equipment companies were left free to charge exorbitant prices, while the general public was left with no real strategy for cost containment. In other words, Brill is impressed with the expanded coverage provided by Obamacare, and depressed about the cost of care...First, there is the improbable story of passing any health care reform in the first place...Then there is the inspiring story of Steve Beshear, Democratic governor of Kentucky, and Carrie Banahan, the civil servant who manages a near-flawless rollout of Kynect, Kentucky’s implementation of the Affordable Care Act that included a properly functioning website...Finally, there is the long story of the botched website debut...enormous admiration at what the president was able to accomplish, calling it a milestone toward erasing a national disgrace...Much of the rising cost of health care comes from overcharging by hospitals, not insurers...refers primarily to the role the pharmaceutical industry plays in gutting any chance for cost effectiveness or price controls...[Brill] has pulled off something extraordinary — a thriller about market structure, government organization and billing practices, by turns optimistic and pessimistic, by turns superficial and insightful, but always interesting, and deadly important.
Posted on: Fri, 09 Jan 2015 23:48:45 +0000
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