- Publisher: Penguin Random House Audio Publishing Gr
- Date: Jan 2015
From the cover
Looking Up from the Gurney
I usually keep myself out of the stories I write, but the only way to tell this one is to start with the dream I had on the night of April 3, 2014.
Actually, I should start with the three hours before the dream, when I tried to fall asleep but couldn't because of what I thought was my exploding heart.
THUMP. THUMP. THUMP. If I lay on my stomach it seemed to be pushing down through the mattress. If I turned over, it seemed to want to burst out of my chest.
When I pushed the button for the nurse, she told me there was nothing wrong. She even showed me how to read the screen of the machine monitoring my heart so I could see for myself that all was normal. But she said she understood. A lot of patients in my situation imagined something was going haywire with their hearts when it wasn't. Everything was fine, she promised, and then gave me a sedative.
All might have looked normal on that monitor, but there was nothing fine about my heart. It had a time bomb appended to it. It could explode at any moment—-tonight or three years from tonight—-and kill me almost instantly. No heart attack. No stroke. I'd just be gone, having bled to death.
That's what had brought me to the fourth—floor cardiac surgery unit at New York–-Presbyterian Hospital. The next morning I was having open—heart surgery to fix something called an aortic aneurysm.
It's a condition I had never heard of until a week before, when a routine checkup by my extraordinarily careful doctor had found it.
And that's when everything changed.
Until then, my family and I had enjoyed great health. I hadn't missed a day of work for illness in years. Instead, my view of the world of healthcare was pretty much centered on a special issue I had written for Time magazine a year before about the astronomical cost of care in the United States and the dysfunctions and abuses in our system that generated and protected those high prices.
For me, an MRI had been a symbol of profligate American
healthcare—-a high—tech profit machine that had become a bonanza for manufacturers such as General Electric and Siemens and for the hospitals and doctors who billed billions to patients for MRIs they might not have needed.
But now the MRI was the miraculous lifesaver that had found and taken a crystal clear picture of the bomb hiding in my chest. Now a surgeon was going to use that MRI blueprint to save my life.
Because of the reporting I had done for the Time article, until a week before, I had been like Dustin Hoffman's savant character in Rain Man—-able and eager to recite all varieties of stats on how screwed up and avaricious the American healthcare system was.
We spend $17 billion a year on artificial knees and hips, which is 55 percent more than Hollywood takes in at the box office.
America's total healthcare bill for 2014 is $3 trillion. That's more than the next ten biggest spenders combined: Japan, Germany, France, China, the United Kingdom, Italy, Canada, Brazil, Spain, and Australia. All that extra money produces no better, and in many cases worse, results.
There are 31.5 MRI machines per million people in the United States but just 5.9 per million in England.
Another favorite: We spend $85.9 billion trying to treat back pain, which is as much as we spend on all of the country's state, city, county, and town police forces. And experts say that as much as half of that is unnecessary.
We've created a system with 1.5 million people working in the health insurance industry but with barely half as many doctors providing the actual care. And most do not ride the healthcare gravy train the way hospital...
Advance praise for America's Bitter Pill
"A landmark study, filled with brilliant reporting and insights, that shows how government really works--or fails to work."--Bob Woodward
"America's Bitter Pill is deeply impressive, an important diagnosis of what America needs to know if we're ever to develop a healthcare system that is fair, efficient, and effective."--Tom Brokaw
"This is one of the most important books of our time. Through revealing personal stories, dogged political reporting, and clear analysis, it makes the battle over Obama's healthcare plan come alive and shows why it matters. It should be required reading for anyone who cares about our healthcare system."--Walter Isaacson
"In America's Bitter Pill, Steven Brill brilliantly ties together not only the saga of Obamacare, but also the larger story of our dysfunctional healthcare system and its disastrous impact on both businesses and ordinary Americans. In a gripping narrative, his thorough reporting is made all the more powerful by his own scary experience looking up from a gurney." - Arianna Huffington