Lost in Obamacare: buried in Steven Brill's convoluted tome are important truths about how to reform our health care delivery system.

• Author: Longman, Phillip

America's Bitter Pill: Money, Politics, Back-Room Deals, and the Fight to Fix Out Broken Healthcare System

by Steven Brill

Random House, 512 pp.

The coming of Obamacare did not lead to the Armageddon of health care inflation that many conservatives predicted, and for that they should show proper humility. But neither did the Affordable Care Act (ACA) relieve the staggering and still-growing burden of America's prosperity-killing health care costs--a reality that progressives need to acknowledge and tackle head on.

The cost of health care is now so high that even historically low percentage increases in medical inflation do serious damage to the economy and household budgets. The total annual cost of health care for a typical family of four covered by a typical employer-sponsored plan reached $22,030 in 2013, or roughly the equivalent cost of buying a brand-new Honda Accord LX every year. That was bad enough, but last year, with the base cost so high, a "mere" 5.4 percent increase in health care costs sucked an additional $1,000 out of such a family's standard of living.

The continually growing burden of health care costs is a major reason why employers are so reluctant to hire and wages remain stagnant. At the same time, even patients with employer-provided plans are paying an ever higher share of the cost of their care (42 percent in 2014) directly out of their own pocket. What moderation we've seen in the rate of increase in health care spending comes not from increases in health care efficiency or decreases in health care prices but from a tough economy combined with the spread of high-deductible health care plans, including those offered on the exchanges under Obamacare, which cause people to forego care they may well need.

Meanwhile, because of our failure to roll back inflated health care prices, a higher percentage of Americans are uninsured today than in 2001. And despite a massive increase in Medicaid spending and insurance premium subsidies offered under Obamacare, a recent Commonwealth Fund survey finds that a higher share of Americans (35 percent) now report difficulties in paying medical bills or have medical debt than in 2005.

Two years ago, Steven Brill published an extraordinary, 24,000-word cover story in Time magazine that took on these issues, concentrating on the profit-maximizing practices of America's so-called "nonprofit" hospitals. Wonky yet filled with compelling human interest anecdotes, the special report offered hope, to me and many others, for the future of both serious journalism and health care reform. Brill and Time appropriately received the National Magazine Award for public interest journalism.

Now comes the inevitable book, based on the original story plus four others that Brill subsequently published in Time. Unfortunately, though Americas Bitter Pill contains important information about how the political economy of health care actually works and in the end comes to strong, if not original, policy prescriptions, it's poorly argued and a pretty dreadful reading experience. You'd be well...