BOOK REVIEWS: Our Health Care Tug-of-War

Steven Brill makes some keen points about what works—and what doesn’t—in our health care system. He’s not so good on what will fix it. BY ADRIANNA MCINTYRE FROM SUMMER 2015, NO. 37 America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System By Steven Brill • Random House • 2015 • 528 pages • $28 Several weeks after the disastrous October 1, 2013, launch of Healthcare.gov, I had dinner with friends who also happened to be reporters on the health-care beat. “We knew it was going to be bad,” one person at the table remarked grimly. “But did we know it was going to be this bad?” On the first day that the federal insurance exchange was online, just six people were able to register for coverage. The site struggled to work for months. But when open enrollment finally ended in April 2014, after several extensions from the Administration, more than eight million people had found coverage through the state and federal insurance exchanges, surpassing projections from the Congressional Budget Office. In America’s Bitter Pill, Steven Brill deftly chronicles this disaster and recovery with a depth of reporting that day-to-day coverage didn’t provide. With the benefit of hindsight and the space of 455 pages of text, Brill is able to trace the stubborn and complex confluence of pressures, inescapable trade-offs, and fallible actors that brought us the nation’s most sweeping health reform in half a century. But Brill, the celebrated investigative journalist, proves to be fallible, too: Rather than stick to reporting, he chooses to play pundit and issue ill-informed prescriptions for our health-care system. His recommendations demonstrate a...