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

John Geyman’s timely book on ACA and single payer
Posted by Don McCanne MD on Thursday, Feb 5, 2015

This entry is from Dr. McCanne's Quote of the Day, a daily health policy update on the single-payer health care reform movement. The QotD is archived on PNHP's website

Right now we have a chance to change history. We should make widely available John Geyman’s book based on sound, effective policy – just what the nation desperately needs..

By John Geyman, M.D.
Copernicus Healthcare, January, 2015

As we all know, the intense debate over Obamacare, or the Affordable Care Act (ACA), is a polarizing issue that sharply divides political parties and the public. Confusion reigns over its benefits, problems and prospects as claims and counterclaims fill press and media coverage.

This book is an attempt to make sense out of all of this - to cut through the rhetoric, disinformation and myths to assess what is good and bad about the ACA, and to ask whether or not it can remedy our system's four main problems - uncontrolled costs, unaffordability, barriers to access, and mediocre, often poor quality of care.

In Part One, we will briefly trace historical roots of various reform attempts over the years, and summarize some of the major trends that have changed the delivery system, professional roles and values, the ethics of health care, and the role of government vs. the private sector. In Part Two, we will compare the ACA's promises with realities of what it has accomplished, examine its initial outcomes on access, cost containment, affordability and quality of care, ask whether its flaws can be fixed with a private insurance industry, and point out the lessons that we can already take away from the first five years of the law. In Part Three, we will discuss the many myths that are perpetuated by opponents of single-payer national health insurance (NHI) and show how that approach stands ready to deal directly with what has become a national disgrace - our increasingly fragmented and cruel health care system that serves corporate interests at the expense of ordinary Americans. We will make the case for NHI in three ways - economic, social/political, and moral. Most other advanced countries around the world came to this conclusion many years ago.

Why this book now? With the 2014 midterm elections behind us, divisions between the parties are even more polarized. The future of health care is even more uncertain. The 2016 election cycle is already underway, and both parties have to confront the failures of yet another incremental attempt to reform our so-called health care system. We have a short year and a half to re-assess where we are and try once again to get health care reform right. As much of the public knows all too well, the stakes get higher every day.

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