All the reform possible

My daughter spent the first six weeks of her life in intensive care. She finally came home, trailed by a long series of bills. The hospitals also sent letters announcing, “This is not a bill,” then detailing what we would owe them if it were—that is, if we didn’t have insurance. The total: more than $250,000. What would we have done with such a bill? Borrowed from every family member and friend we have? Filmed a heartstrings-tugging fund-raising video? Gone bankrupt?

I know others who have gone through something similar and have concluded that the U.S. health-care system is broken and that Obamacare has done little to fix it. Are they right? Does the signature progressive achievement of the Obama years represent only minimal progress?

Journalist Steven Brill’s first deep dive into health care was his massive 2013 Time article on “chargemasters”: hospitals’ minutely itemized and often wildly inflated price lists, on which they base the bills they send the uninsured and the nonbills they send people like me. Now Brill has written a detailed account of the Affordable Care Act—its origins, enactment, implementation, and future outlook. He concludes with his own prescription for health-care reform. The prescription is underwhelming, but the bulk of the book is invaluable.