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How Obamacare Is Unsustainable: Why We Need a Single-Payer Solution For All Americans

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Confusion and controversy have plagued the Affordable Care Act (ACA or Obamacare) since its enactment in March 2010. Republicans have generally opposed the legislation and attempted to obstruct it in parts or repeal it altogether. Democrats have tended to support it, defending it against the opposition but wary of some of its problems. Patients and families are caught in t Confusion and controversy have plagued the Affordable Care Act (ACA or Obamacare) since its enactment in March 2010. Republicans have generally opposed the legislation and attempted to obstruct it in parts or repeal it altogether. Democrats have tended to support it, defending it against the opposition but wary of some of its problems. Patients and families are caught in the middle as the debate heats up in election years. How Obamacare is Unsustainable is the first book to take an evidence-based approach to assessment of the good and bad about this signature domestic legislation of the Obama presidency after five years of experience. The evidence already shows that the three major aims of the ACA—to provide near-universal access to health care, to contain costs and make health care affordable, and to improve the quality of U.S. health care—are not being met. Evidence and experience show that the ACA’s approach to health care reform will not work. As it fails, the big question is what next? Th e case is made—on economic, social and moral grounds—that a single-payer improved Medicare for all system will meet the ongoing goals of reform. Th is book explains how all Americans can gain universal access to comprehensive health care, paying less than we do now, with more value and less bureaucracy.


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Confusion and controversy have plagued the Affordable Care Act (ACA or Obamacare) since its enactment in March 2010. Republicans have generally opposed the legislation and attempted to obstruct it in parts or repeal it altogether. Democrats have tended to support it, defending it against the opposition but wary of some of its problems. Patients and families are caught in t Confusion and controversy have plagued the Affordable Care Act (ACA or Obamacare) since its enactment in March 2010. Republicans have generally opposed the legislation and attempted to obstruct it in parts or repeal it altogether. Democrats have tended to support it, defending it against the opposition but wary of some of its problems. Patients and families are caught in the middle as the debate heats up in election years. How Obamacare is Unsustainable is the first book to take an evidence-based approach to assessment of the good and bad about this signature domestic legislation of the Obama presidency after five years of experience. The evidence already shows that the three major aims of the ACA—to provide near-universal access to health care, to contain costs and make health care affordable, and to improve the quality of U.S. health care—are not being met. Evidence and experience show that the ACA’s approach to health care reform will not work. As it fails, the big question is what next? Th e case is made—on economic, social and moral grounds—that a single-payer improved Medicare for all system will meet the ongoing goals of reform. Th is book explains how all Americans can gain universal access to comprehensive health care, paying less than we do now, with more value and less bureaucracy.

14 review for How Obamacare Is Unsustainable: Why We Need a Single-Payer Solution For All Americans

  1. 4 out of 5

    Mark

    If you need the police, you call 911. You don't have to pay them to come, they just come. Their salaries are paid for by your taxes. It would be unfair and unAmerican to have a system where the police only help the rich. This is a form of socialism, but that's the best way to do it - we all agree. So why do we let doctors, hospital and health insurance companies take care or our health as a for profit business? It is an unfair, inefficient and avaricious way to take care of sick people. Read thi If you need the police, you call 911. You don't have to pay them to come, they just come. Their salaries are paid for by your taxes. It would be unfair and unAmerican to have a system where the police only help the rich. This is a form of socialism, but that's the best way to do it - we all agree. So why do we let doctors, hospital and health insurance companies take care or our health as a for profit business? It is an unfair, inefficient and avaricious way to take care of sick people. Read this book to find out why we need national health care like the other developed countries have. The author is a well-known professor of family medicine. The book is short and clear with many quotations from the interested parties. I had to add this book to the goodreads database. I bought it online from the physicians for national healthcare bookstore.

  2. 5 out of 5

    Sarah Wynker

    Really good book to understand "Obamacare" without the usual chatter. However, I must admit that it was a little dense for me in parts. If I had a better grasp of health care in the US, the reading would have been much smoother.

  3. 5 out of 5

    Kevin Mabry

  4. 4 out of 5

    Victoria Randall

  5. 5 out of 5

    Patrick Cate

  6. 5 out of 5

    Pacific Lee

    Dr. Geyman here has written an epic piece of work, extremely well organized arguments with hundreds of supporting footnotes. The first half of the book is dedicated towards slamming the ACA: crony capitalism, subpar results for the $1 trillion pricetag (only half of the uninsured have enrolled, employers skirt requirements, underinsurance still an issue, etc.), the botched roll-out and byzantine complexity... Then the arguments for single-payer are laid out: lowered administrative costs/complexity Dr. Geyman here has written an epic piece of work, extremely well organized arguments with hundreds of supporting footnotes. The first half of the book is dedicated towards slamming the ACA: crony capitalism, subpar results for the $1 trillion pricetag (only half of the uninsured have enrolled, employers skirt requirements, underinsurance still an issue, etc.), the botched roll-out and byzantine complexity... Then the arguments for single-payer are laid out: lowered administrative costs/complexity, greater choice, more "equity" in terms of access, decreased cost from feds being able to negotiate with industry, etc. Many of the reservations that I have held were somewhat alleviated by Dr. Geyman, such as the fear of increased costs (I can see now how streamlined bureaucracy may help reduce expenditures). But several major concerns still remain unaddressed, or underaddressed. My biggest concern is the incredible expansion of centralized government that the single payer system would entail. Healthcare comprising 1/6 of the national economy, greater than the entire GDP of France, would be an enormous sector to exert influence over. There is tremendous potential for abuse of power by the state when everybody is reliant upon it for literal sustenance. The government would have the power to determine "what services or procedures are necessary, appropriate, or cost effective" (p.234). Secondly, it is important to see past the class-based rhetoric when talking about profits to the pharmaceutical, medical device, and other related industries. Single-payer would necessarily entail huge cuts to their profit margins, and this in turn would inevitably lead to decreases in innovation, this is a fact given the incredible costs to R&D in drug manufacturing, for instance. Dr. Geyman dedicates a single page to this issue (p.235) Thirdly, I would like to point out that access to healthcare is not the same thing as being covered. Rationing will happen regardless of the payment system, the author acknowledges this. Quality healthcare is a limited resource, even more so when it is "free", and in societies that do not ration by money, they must ration by time or other factor (suggested here is a centralized committee of experts). Efficacy here is questionable. Lastly, there is the issue of pragmatism. In comparing the USA to Canada, you have to realize that we have 10x the population. There is no comparison in the Western world, where a collection of 310 million people are scattered across a huge expanse of land in all of their ethnic/ cultural diversity. Going back to the economic scale of the government intervention mentioned above, it just doesn't seem feasible, at least in the near-term. More so considering how the ACA was passed without a single GOP vote (destined to forever be politicized), and especially considering the size of the vested interests in opposition to the plan. I could also question the ethics of stealing from the wealthy to fund this operation, but I understand that sometimes this may be necessary for the better good. This book is worth a read if you want to understand the perspective of the healthcare issue from the leftist point of view. It will help, at the very least, to clarify your own positions on the matter.

  7. 4 out of 5

    Adrian

  8. 5 out of 5

    Sharron Murray

  9. 4 out of 5

    Deborah Hornstra

  10. 4 out of 5

    Noemi Elizabeth

  11. 5 out of 5

    randy hicks

  12. 5 out of 5

    Ali Sheikh

  13. 5 out of 5

    Michael

  14. 5 out of 5

    Sean

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