File Size: 4189 KB
Print Length: 530 pages
Publisher: Random House (January 5, 2015)
Publication Date: January 5, 2015
Another reviewer refers to Bismark's dictum that certain should not watch either laws or meat being made, plus the very first half of Brill's guide demonstrates that -- exhaustively and and times exhaustingly. He shows how it had been that, even with a Democratic majority in the two houses, lobbyists for specific interests (the drug firms, the insurers, the clinics, the device makers, the particular patient's groups, and on in addition to on and on) could actually force those in favor of reform to normal water down proposals, compromise, purchase off, and on and about an on. In so doing, I learned a lot about the economics and the energy structure of the U. S. medical care system, yet I also learned more than I probably wished to know about a number of too many individuals. I also learned (or had been confirmed in my belief) that within the Obama administration there were main divisions of opinion in addition to major shortages of connection.
The second part associated with the book, on what occurred after the legislation had been passed, was more exciting -- or perhaps more accurately less exhausting. 1st, in this part, Brill intersperses the political story with stories of individuals who ran into financial catastrophe through illness, in addition to looks at what varioius institutions (mostly hospitals) do to bring these individuals close to financial ruin. 2nd, his narrative of the particular failed launch of the particular Obamacare website is eyeopening -- the launch unsuccessful because the project had been badly run from its creation, and that reflected negative management by the supervision, all the way up to the particular top. That, nevertheless , will be followed by the livliest part of the guide, in which a " Geek Squad" of generally private sector techies helps you to save the day. There will be a lot in this area to gratify anti-Obama sorts and anti-govenment types, yet only if you read it in isolation from your context. That context any of " non profit" hospitals with CEO's that earn millions a 12 months, drug companies whose loyalty to analyze is far surpassed by way of a devotion to their own profit margins, and a good overall situation in which usually the consumer of health-related comes in last.
From the end of the particular book, Brill argues that there is no method that the U. S. health-related system can be rebuilt from the ground in a way that would certainly minimize costs and maximize outcomes. That would mean individual payer, it would mean Medicare drug price negotiation if not drug price regulation, it would mean serious research on comparative outcomes and costs, and this means a whole whole lot of other violent in order to one-sixth of the U. S. economy. That sixth includes a very powerful attention in resisting change, although the five-sixths of the particular economy that would advantage has a more diffuse interest. Granted that, he proposes that perhaps we all should consider making the particular institutions that directly supply more and more U. S, health care care --the hospitals -- into insurers as nicely as providers. It's an interesting idea that sounds a little like handing the particular whole henhouse over to the fox, but this bears discussion. As to Obamacare, Brill concludes that it was a main accomplishment, in that it introduced healthcare into the reach associated with many more Americans. Still, Brill argues it turned out basically tinkering with the jalopy, not putting in a new engine.
This guide is the best total summary of the U. S. healthcare situation that I have read in years, which is why five stars. It can have been an improved guide, better organized and much more readable. Still, I think it truly is one of those books you should read actually if it takes work., Whether or not you support Obama Care, you must read this book. A brilliant creator and reporter, Brill cautiously documents how various lobby groups interfered with the legislative process during the creating of the Affordable Health Care Act. He likewise discusses his personal medical activities.
The problem with modern day health care, the creator suggests, is not that " liberals' are trying to socialize health care. Most mixed up in legislation appear to possess genuinely desired health proper care for all. Nevertheless the devil is in the information. As is, Obama Care cannot work.
The real issue is cost. How could we adequately insure all Americans when medical charges are skyrocketing? When so-called " nonprofit" hospital reek in billions in earnings? When pharmaceutical companies will certainly not make price concessions for groups? When manufacturers of medical devices make obscene profits? When providers duplicate each others gear?
Here in Pittsburgh, the particular dominant (and dominating) health-related provider is UPMC. The CEO earns , 000, 000 a year. Within half a dozen months profits rose by simply million. In the particular meantime, even those together with Obama care policies possibly cannot afford the premiums or face enormous co-pays and deductibles. Something must be done., This is a very informative but unsettling account of how the Cost-effective Care Act (ObamaCare) had been created. It includes several of the ways our own healthcare system is damaged and possible ways to improve it. There will be a huge amount info as to the national politics of creating the device. A lot on the backroom bargains needed to keep this from being sabotaged, inclucing deals with drug manufacturer lobbies, hospital lobbies, risks by the Republicans to stop its passage etc. It almost always ends with a few suggestions for how to move ahead although these are not necessarily with a way to offer with the destructive national politics involved. I found this very eye opening although depressing to learn exactly how watered down it turned out there and how much national politics played a role in preventing its developing the potential. For me, this has too much detail and was too extended, but I guess that detail is necessary to prove that the assertions he can make are true. I would recommend this., Steven Brill has been doing the particular impossible: he has made the utterly mind-numbing issue of "Modern American Healthcare" actually understandable! From the particular early Blues (health insurance policy companies) in Texas to IRS decisions on "to tax health benefits or not? " (those meddling unions) to Nixoncare to Hillarycare to Romneycare to Obamacare... & all that will be before the 10% tag!
I have been searching for something to read that would give me the particular information showing how did we all get to this level anyway? I found this here. Although this guide is informative, it is not a textbook. The author weaves personal experiences in that illustrate his points profoundly. If you want to know what's heading on, read this guide., As a doctor in the US, I see the particular problems inherent in our own medical system from the particular inside every day. This book is not just concerning Obamacare, but about the particular sorry state in our well being care in general. The author clearly, and often infuriatingly, explains why Obamacare ended up being thus ineffectual, limited, and sprinkled with unintended consequences because a result of all the compromises in favor of special interest organizations who made sure a real reform would not necessarily be passed.
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