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America's Bitter Pill
- Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System
- Narrated by: Dan Woren
- Length: 17 hrs and 10 mins
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Publisher's Summary
New York Times best seller. A New York Times notable book.
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 health-care “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 health care so that it stops draining the bank accounts of our families and our businesses and the federal treasury.
Praise for America’s Bitter Pill:
“A tour de force...a comprehensive and suitably furious guide to the political landscape of American healthcare...persuasive, shocking.” (The New York Times)
“An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy.... [Brill] has pulled off something extraordinary.” (The New York Times Book Review)
“A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’” (Los Angeles Times)
“A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.” (The Daily Beast)
“One of the most important books of our time.” (Walter Isaacson)
“Superb...Brill has achieved the seemingly impossible - written an exciting book about the American health system.” (The New York Review of Books)
Critic Reviews
"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)
"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)
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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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- Andrew S. Breza
- 01-14-15
Great history, questionable solutions
Steven Brill offers the most complete history to date of the roll out of the Affordable Care Act (Obamacare). He gives a behind the scenes perspective that spares no one, be it Congressional Democrats who passed the ACA using back room deals, Republicans who opposed the law without offering an alternative, or the leaderless and bumbling effort by the Obama administration to implement health insurance exchanges. The book gives a solid, albeit opinionated, history until its end, where Brill steps out of his role as historian to speculate about how he would fix America's healthcare system if given the power. His prescriptions for success are interesting but unconvincing, giving an otherwise impressive bit of modern history a tepid coda.
18 people found this helpful
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- audrey s
- 05-14-15
Good facts but sometimes one sided conclusions
It had some good information although not particularly revelatory if you were at all politically aware during the implementation of the ACA. Personally I feel the author did every sort of logical (or non-logical) mental gymnastics to come to the conclusion that is spite of all of the problems with its passage and implementation, the country is better off because of the ACA , and now all we have to do is pass more regulations through, for example, the FTC so that we really fix health care for good. I tried to keep an open mind during this story but still come to the opposite conclusion. In spite of the authors attempt to convince me otherwise, I think the ACA is and will make America worse off in the long run. Regardless of my opinion about the ACA,
the book itself was decent.
17 people found this helpful
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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.
14 people found this helpful
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- Pete
- 04-18-17
"In Defense of the ACA" is a more appropiate title
Would you try another book from Steven Brill and/or Dan Woren?
Steven Brill - No
Dan Woren - Yes
Would you ever listen to anything by Steven Brill again?
No
Any additional comments?
Completely biased analysis. Author is incapable of lending a serious critical eye on the shortcomings of the ACA and where it desperately needs improvement. The author focuses on a handful of cases where patients benefitted from the act while completely ignoring those negatively impacted.
9 people found this helpful
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- DaWoolf
- 03-02-15
The agony and ecstasy of Obamacare
Steven Brill provides a critical analysis of the development and implementation of the Affordable Care Act (ACA). Brill starts with the 2008 Democratic Primary, where Barak Obama seemed underprepared to provide a substitutive healthcare plan compared to Hillary Clinton. Recognizing his short-comings, Obama launches himself into the issue that will serve to define his legacy. Brill provides the details on the political deals, players, compromises, and negotiations that allowed the ACA to become law.
Brill does an expert job to describing the ACA registration rollout fiasco and the herculean efforts needed to create a functional enrollment website under immense political pressure. There are also numerous stories of ordinary people with significant health conditions and how they were affected by the ACA.
The problem with America’s Bitter Pill (ABP) is the big take away, although universal health coverage is terrific the ACA lacks the regulations to contain consumer costs. This issue is due to the fact that the ACA was written to protect the financial interests of insurance providers, hospitals, pharmaceutical companies and medical equipment suppliers. ABP reminded me of Otto von Bismarck’s famously stated quote “Laws are like sausages, it is better not to see them being made.”
9 people found this helpful
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Overall
- Robert B.
- 06-26-19
"one biased persons opinion on healthcare stuff"
is what it should have been titled. the author demonstrates the ability to hold two conflicting views at the same time: at once chronicaling the federal government's near complete failure to execute on something as simple as a website and at the same time extolling the virtues of government run healthcare. at the same time vilifying private sector business, he notes that only when private sector business people got involved was the debacle saved. the degree to which his opinions on the pharmaceutical industry and hospital charges were I'll informed causes me to call into question his claims in other areas. I'll never get that time back.
6 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.
6 people found this helpful
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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.
5 people found this helpful
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- Customer in DC
- 03-24-15
Fascinating, insightful, and entertaining
I rarely do book reviews. As former Hill staff close to this topic, I completely enjoyed the behind the door stories, easily digestible yet compelling data, and hopeful suggestions at the end. I highly recommend everyone having any strong views on this topic first read this book and reexamine one's, including my, probably limited understanding. Last but importantly, this book is long but highly entertaining.
2 people found this helpful
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- Cindy Cooper
- 02-07-18
For those who want to know
Excellent documentation for those who want to know how we got where we are with healthcare in the U.S.
1 person found this helpful
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-
Story
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. Dr. John Abramson reveals the inside story of how Big Pharma’s relentless pursuit of ever-higher profits corrupts medical knowledge.
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it really was sickening
- By Adrian Garcia on 03-21-23
By: John Abramson
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Reframing Healthcare: A Roadmap for Creating Disruptive Change
- By: Zeev E. Neuwirth MD
- Narrated by: Zeev E. Neuwirth MD
- Length: 7 hrs and 9 mins
- Unabridged
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Overall
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Performance
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Story
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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Unaccountable
- What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
- By: Marty Makary
- Narrated by: Robertson Dean
- Length: 7 hrs and 16 mins
- Unabridged
-
Overall
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Performance
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Story
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.
- By Julie on 06-11-16
By: Marty Makary
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The Price We Pay
- What Broke American Health Care - and How to Fix It
- By: Marty Makary MD
- Narrated by: Marty Makary MD
- Length: 9 hrs and 29 mins
- Unabridged
-
Overall
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Performance
-
Story
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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Priced Out
- The Economic and Ethical Costs of American Health Care
- By: Uwe E. Reinhardt, Paul Krugman - Foreword by, William H. Frist - Foreword by
- Narrated by: Bob Souer
- Length: 4 hrs and 13 mins
- Unabridged
-
Overall
-
Performance
-
Story
Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's US health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.
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A great book for someone who studies healthcare and economics
- By Samuel on 06-03-19
By: Uwe E. Reinhardt, and others
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An American Sickness
- How Healthcare Became Big Business and How You Can Take It Back
- By: Elisabeth Rosenthal
- Narrated by: Nancy Linari
- Length: 13 hrs and 38 mins
- Unabridged
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Overall
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Performance
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Story
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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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
- Unabridged
-
Overall
-
Performance
-
Story
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. Dr. John Abramson reveals the inside story of how Big Pharma’s relentless pursuit of ever-higher profits corrupts medical knowledge.
-
-
it really was sickening
- By Adrian Garcia on 03-21-23
By: John Abramson
-
Reframing Healthcare: A Roadmap for Creating Disruptive Change
- By: Zeev E. Neuwirth MD
- Narrated by: Zeev E. Neuwirth MD
- Length: 7 hrs and 9 mins
- Unabridged
-
Overall
-
Performance
-
Story
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.
-
-
Great content and resources
- By Galen on 07-12-19
-
Unaccountable
- What Hospitals Won't Tell You and How Transparency Can Revolutionize Health Care
- By: Marty Makary
- Narrated by: Robertson Dean
- Length: 7 hrs and 16 mins
- Unabridged
-
Overall
-
Performance
-
Story
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.
-
-
Everyone should read this book.
- By Julie on 06-11-16
By: Marty Makary
-
The Price We Pay
- What Broke American Health Care - and How to Fix It
- By: Marty Makary MD
- Narrated by: Marty Makary MD
- Length: 9 hrs and 29 mins
- Unabridged
-
Overall
-
Performance
-
Story
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.
-
-
Very important book!
- By Wayne on 05-17-21
By: Marty Makary MD
-
Priced Out
- The Economic and Ethical Costs of American Health Care
- By: Uwe E. Reinhardt, Paul Krugman - Foreword by, William H. Frist - Foreword by
- Narrated by: Bob Souer
- Length: 4 hrs and 13 mins
- Unabridged
-
Overall
-
Performance
-
Story
Uwe Reinhardt was a towering figure and moral conscience of health care policy in the United States and beyond. Famously bipartisan, he advised presidents and Congress on health reform and originated central features of the Affordable Care Act. In Priced Out, Reinhardt offers an engaging and enlightening account of today's US health care system, explaining why it costs so much more and delivers so much less than the systems of every other advanced country, why this situation is morally indefensible, and how we might improve it.
-
-
A great book for someone who studies healthcare and economics
- By Samuel on 06-03-19
By: Uwe E. Reinhardt, and others
-
The Innovator's Prescription
- A Disruptive Solution for Health Care
- By: Clayton M. Christensen, Jerome H. Grossman, Jason Hwang
- Narrated by: Scott Pollak
- Length: 13 hrs and 34 mins
- Unabridged
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Overall
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Performance
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Story
Our health-care system is in critical condition. The Affordable Care Act has insured more Americans than ever, yet deductibles keep rising and costs continue to climb. Now more than ever, the industry needs a shot in the arm. It needs The Innovator's Prescription, the now-classic approach to efficient, affordable health care.
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Predicted the future pretty well
- By VB on 03-21-22
By: Clayton M. Christensen, and others
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Drugs and the FDA
- Safety, Efficacy, and the Public's Trust
- By: Mikkael A. Sekeres
- Narrated by: Mike Lenz
- Length: 8 hrs and 40 mins
- Unabridged
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Overall
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Performance
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Story
Food and Drug Administration approval for COVID-19 vaccines and the controversial Alzheimer's drug Aduhelm made headlines, but few of us know much about how the agency does its work. Why is the FDA the ultimate United States authority on a drug's safety and efficacy? In Drugs and the FDA, Mikkael Sekeres—a leading oncologist and former chair of the FDA's cancer drug advisory committee—tells the story of how the FDA became the most trusted regulatory agency in the world.
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Metastic
- By Anne E. Sharman on 05-07-23
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Make America Healthy Again
- How Bad Behavior and Big Government Caused a Trillion-Dollar Crisis
- By: Nicole Saphier
- Narrated by: Emily Durante
- Length: 8 hrs and 54 mins
- Unabridged
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Overall
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Performance
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Story
In Make America Healthy Again, Nicole Saphier, a Memorial Sloan Kettering physician, nationally recognized patient advocate, and media personality, reveals how individual negligence and big government incompetence have destroyed America's health care system. Combining historical events, economic trends, and essential lifestyle advice, with her unique perspective, she offers concrete solutions to address this epic problem.
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Engaging and Comprehensive
- By JES on 07-26-21
By: Nicole Saphier
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Which Country Has the World's Best Health Care?
- By: Ezekiel J. Emanuel
- Narrated by: Rick Zieff
- Length: 16 hrs and 41 mins
- Unabridged
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Overall
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Performance
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Story
The US spends more than any other nation, nearly four trillion dollars, on health care. Yet, for all that expense, the US is not ranked number one - not even close. In Which Country Has the World's Best Healthcare? Ezekiel Emanuel profiles 11 of the world's health-care systems in pursuit of the best or at least where excellence can be found.
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Confusing..
- By Cristi on 11-18-20
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Uncaring
- How the Culture of Medicine Kills Doctors and Patients
- By: Robert Pearl MD
- Narrated by: James Fouhey
- Length: 13 hrs and 17 mins
- Unabridged
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Overall
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Performance
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Story
Hardly anyone is happy with American health care these days. Patients are getting sicker and going bankrupt from medical bills. Doctors are burning out and making dangerous mistakes. Both parties blame our nation’s outdated and dysfunctional health care system. But that’s only part of the problem. In this important and timely book, Dr. Robert Pearl shines a light on the unseen and often toxic culture of medicine.
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Important to understand the current medical world
- By DMM on 07-12-21
By: Robert Pearl MD