America’s Bitter Pill

Steven Brill Random House, 528 pages, $28 Compelling back story of the Affordable Care Act


Journalist Steven Brill, who strode to health care policy prominence with his 2013 Time magazine cover story on out-of-control hospital costs, is back, this time with a full-length book, “America’s Bitter Pill: Money, Politics, Back-Room Deals and the Fight to Fix Our Broken Healthcare System,” that looks at the ups, downs and website crashes for what’s now commonly referred to as Obamacare.

Brill takes readers through the ­failed history of health care reform in America, picking up both detail and speed with the 2008 presidential campaign. Few may recall now that candidate Barack Obama was slow to warm to the idea of requiring everyone to buy health insurance; the individual mandate is now a cornerstone of the Affordable Care Act he signed into law two years later.

Some (many?) may be tired, or simply disinterested, in a retelling of the Affordable Care rollout. Terms such as “medical loss ratio” and “biosimilars” aren’t likely to come up at any cocktail parties. But anyone interested in how Washington works will find plenty to chew on here. Little of it is surprising, but the tale is compelling, nonetheless. As with his earlier Time magazine piece, Brill makes repeated mention of the astronomical charges associated with medical care, and the book’s opening anecdote — a personal one — is revealing on that front.