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Profiteering, corruption and fraud are emblematic of our profit-driven, corporatized marketplace and so-called health care system. The three bleed into each other in an entangled way, and they are even increasing.ΓÇ¿We have to ask and answer: who is the health care system for- profits for health care corporations, their shareholders, and Wall Street traders and investors? for the corrupt and fraudulent scammers? or for patients, their families, and taxpayers? The urgent need for health care reform is at an all-time high as the U. S. struggles to deal with the COVID-19 pandemic and the recession certain to follow. We are far behind other advanced nations with one or another system of universal coverage.ΓÇ¿Incremental attempts to reform U. S. health care have failed for many years. Our broken system is no longer affordable for patients, families, and taxpayers.This book updates where we are with the untenable status quo and compares three major alternatives for reform-building on the ACA, the public option, and Medicare for All.
The problems of U.S. health care are of intense public interest today. The debate over where to go next to rein in costs and improve access to quality health care has become bitterly partisan, with distorted rhetoric largely uninformed by history, evidence, or health policy science. Based on present trends, our expensive dysfunctional system threatens patients, families, the government, and taxpayers with future bankruptcy.This book takes a 60-year view of our health care system, from 1956 to 2016, from the perspective of a family physician who has lived through these years as a practitioner in two rural communities, a professor and administrator of family medicine in medical schools, a journal editor for 30 years, and a researcher and writer on health care for more than four decades.There has been a complete transformation of health care and medical practice over that time from physicians in solo or small group practice and community hospitals to an enormous, largely corporatized industry that has left behind many of the traditions of personalized health care. This is an objective, non-partisan look at the major trends changing U.S. health care over these years, and points out some of the highs-and lows-of these changes, which may surprise some readers. It also compares the three basic alternatives for health care reform currently being debated.
The Republican-controlled Congress has failed to repeal and replace the Affordable Care Act (ACA) or ObamaCare, over the last eight years, and there is widespread confusion and uncertainty as to what is going on in U. S. health care. Most Americans are increasingly anxious about whether they can afford their own health insurance and health care. Even those who are covered by Medicare and Medicaid are worried about threatened cutbacks to these programs as congressional Republicans commit themselves to slashing "entitlement" funding to help pay down the $1.5 trillion deficit resulting from passage of their 2017 tax bill. The ACA has been so undermined and sabotaged by the Trump administration that it is now owned by Trump and the GOP as TrumpCare. Chaos now reigns throughout our increasingly fragmented, dysfunctional, and unfair health care system. This book intends to make sense out of this chaos with four goals: (1) to describe what TrumpCare is; (2) to show how it will fail patients, families, taxpayers, and the nation; (3) to describe the growing crisis in health care in this country; and (4) to compare the only two real alternatives before us-continuance of TrumpCare or moving to single-payer Medicare for All. Recent national polls show that health care is the # 1 concern of the electorate, even above the economy, as the 2018 midterms approach. This book describes how Americans can gain universal access to affordable health care, with higher quality and less bureaucracy, paying less than we do now.
U. S. health care remains in crisis despite the passage of the Affordable Care Act (ACA) in 2010. The markers are serious-29 million still uninsured, 85 million underinsured, soaring costs of health care with no containment in sight, and growing numbers of people forgoing medical care and dying preventable deaths. After failing to repeal the ACA, the Trump administration and GOP have sabotaged it in many ways, such as by allowing insurers to deny coverage based on pre-existing conditions. Private health insurers are ripping us off by administrative overhead and profits six or more times the overhead of not-for-profit public Medicare. Incremental approaches toward health care reform will fail. We need real Medicare for All with comprehensive benefits for all U. S. residents. We can afford it through savings of private insurer costs, negotiated drug prices, and progressive taxes whereby 95 percent of Americans will pay less than they do now for insurance and health care. This book charts the way to real reform based on Democratic control of the House and 70 percent of Americans supporting Medicare for All.
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