America's Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System
by Steven Brill
View on GoodreadsBrill reports the making of the Affordable Care Act from both ends at once — the lobbying and legislative bargaining that produced the bill, and the hospital and insurer economics it deliberately left alone — then ends up inside the system himself after emergency open-heart surgery. His verdict is that the law expanded access while leaving the pricing machinery that makes American healthcare uniquely expensive completely untouched.
Core ideas
- The law was written to buy the industry's acquiescence, so it added paying customers without touching what those customers would be charged
- The chargemaster — the list price no hospital can explain or defend — is where the money actually sits, and reform left it entirely intact
- Consolidated hospital systems now hold more pricing power than the insurers negotiating against them, which makes them the actor any real reform has to confront
Published2015
Pages512
ISBN9780812996951
ReadAug 2026
