****** - Verified Buyer
4.5
The author does a superb job of describing health care and insurance in America, with the development and current status of Obamacare as the point from which to view many aspects of these topics and the political, economic and patient interests and forces that affect them. He has done a marvelous job of researching and even-handedly describing the chronological development of the Affordable Care Act as it passed from concept, to bill to law.I have been following the law closely for years, aided by excellent coverage in the Washington Post and the book Landmark: The Inside Story of America's New Health-Care Law-The Affordable Care Act-and What It Means for Us All (Publicaffairs Reports) that was published by the Post staff, which was outstanding on provisions of the law but rather summary in describing its development. My keen interest in health care and insurance as a retiree from the Dept. of the Navy stems from being a fifteen year survivor of a once life-threatening case of highly aggressive prostate cancer, which finally may have been cured. My treatment has been expensive, though my excellent insurer has borne most of the expense. Even though I was relatively well informed, I learned a lot from this book and feel I now have much better understanding of American health care and insurance, including both successes and serious problems. After reading the book, I'm in even greater awe of President Obama's determination to achieve better health care, and I'm even more puzzled why the Republican Party has both been so obstinate in opposing better insurance for our country and yet been so successful in convincing so many Americans that it is acting in their best interest. I'm also disappointed that the Administration did such a poor job of overseeing implementation of the web site and the insurance exchange system including implementing regulations, a fact that the book clearly documents. (I've added a postscript below in a comment about that. I especially appreciate the author's excellent coverage of this aspect.) I learned about many important players in the development of Obamacare, especially including former Senator Max Baucus of Montana. At the end of the book the author sums up his own thoughts and recommendations, which I found thought provoking and encouraging.The book is very well written and entertaining, which is achieved through many stories of events and issues. The author is insightful, clearly a talented journalist, and savvy about politics, economics and healthcare. He brings his own experience of an aortic aneurysm, using that as a prism to present both encouraging and harsh realities. He was diligent in his research, including interviews with 243 people, often more than once, many of the interviews with key people in the Obamacare story, including President Obama. He provides an excellent list of sources for the points in each chapter, and the index is very good. While the book is not designed as a text book, it is scholarly.I would dearly like to discuss health care and insurance with the author at a coffee shop. I would tell him how much I appreciated his wonderful book, but I would also discuss with him one important area where I feel he is underestimating the impact of the Obamacare law - its substantial impact in putting downward pressure on health care costs. It's likely that the author became frustrated that the law did not do more to lower cost, but perhaps as a long-term cancer patient I see more clearly that some important cost reductions have been achieved. For instance, while a premium of several thousand dollars, say $5,000, and a high deductible of, say, $12,000 puts some unsubsidized families at risk of $17,000 in medical /insurance expenses - a scenario the author visits several times, nevertheless the vast majority of families will have relatively minor out-of-pocket costs for most years and will fall far short of the deductible. Meanwhile, the cost of their exams, labs, treatments and drugs will be far lower than these costs would have been if the families were uninsured, saving them a ton of money during the period prior to reaching the deductible. I did not feel this reality was presented in the book, but cost reductions due to the Obamacare law is one of the few places where I would have suggested a different approach.I'll close with a list of four people who strongly endorsed this book on the back cover: Bob Woodward, Tom Brokaw, Walter Isaacson, and Arianna Huffington - quite an impressive list!
