The Human Face of Obamacare: Promises vs. Reality and What Comes Next

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9781938218026: The Human Face of Obamacare: Promises vs. Reality and What Comes Next
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This book shows the human face of the Affordable Care Act (ACA or ObamaCare) as the stories of real patients and their families best illustrate continuing problems of our health care system. It also shows how many of the promises made by the Obama administration have not been kept. The big question now is: “What next?” The ACA has helped many millions of people since its enactment in 2010, but has fallen far short of what is needed to improve access, affordability, and quality of U. S. health care. Much of our population still cannot afford health care, and there is no cost containment in sight. Underinsurance is the new norm, with narrowed networks, high deductibles, and increasing cost-sharing forcing many people to forego necessary care. Here we take a comprehensive, non-partisan, objective look at the ACA almost six years after its passage. We also take an evidence-based approach to assessing three major alternatives for further health care reform: (1) continuation of the ACA with improvements as needed, (2) Republican proposals for its repeal and/or replacement, and (3) single-payer national health insurance (NHI).

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From the Author:

Now that the Affordable Care Act (ACA) has been upheld by the U.S. Supreme Court as the law of the land, it is the target of an intense partisan debate during this 2016 election cycle. Confusion, disinformation, and misleading rhetoric dominate the airwaves as politicians and their corporate backers offer up wildly different approaches to our health care problems and solutions.
After six years with the ACA, there is a large base of experience to draw upon to assess, on the basis of evidence, what has worked and not worked. So it is time to reassess its impacts on the problems it was intended to address--reduced access to health care, uncontrolled costs, increasing unaffordability, and unacceptable quality of care for our population.
Despite promises of the Obama administration before the law was passed that we can keep our insurance if we like it, stay with our same doctors, and save money at the same time, many millions of Americans have too often found these assurances to be empty. Having insurance "coverage" for many does not translate into having access to affordable necessary care. Instead, the largely for-profit "system" continues on, profiting and sometimes profiteering from expanded markets subsidized by us, the taxpayers. The original title of the ACA as the Patient Protection and Affordable Care Act (PPACA) has become a misnomer, not surprisingly little used today.  
Too we are often bombarded by abstract numbers and statistics that neglect what they mean to ordinary Americans. This book takes a different approach, starting with stories of patients and their families, thereby putting a human face on the large body of experience and evidence about the effects of the ACA since its passage in 2010.  Far from isolated anecdotes, these are common stories that best illustrate national trends and problems in our increasingly dysfunctional market-based system.
The book is organized in three parts: Part One presents some 50 patient and family stories that represent problems confronted by implementation of the ACA since 2010. These are real people and their families drawn from press reports. Part Two looks at five major problems of the entire system, as we consider to what extent the ACA has addressed them, and find that we are far from the health care reform that we need. Part Three deals with where we are now, in the middle of an election year, faced with three main alternatives about where to go next: (1) stick with the ACA or try to improve it; (2) repeal and replace it with a Republican "plan"; or (3) move to single-payer system of national health insurance. You will notice that many of the chapters start with a heading, "The Promise", "The Premise," or "The Myth." These denote either the promises made by the Obama administration about the ACA or the premises underlying it, which typically and ironically are based on earlier conservative ideas put forward by conservative organizations, such as the Heritage Foundation.
The stakes are too high to get health care wrong in this country. Our incremental reform attempts over many years have been compromised by the money and political power of corporate stakeholders that perpetuate many of our problems. We need objective evidence to combat the rhetoric and claims of the medical-industrial complex and direct our attention to the  real needs of patients and their families. It is my hope that this book will help in this process.
--John Geyman, M.D.  
Friday Harbor, WA
January 2016

From the Back Cover:

"In his new book, Dr. Geyman takes us beyond abstract numbers to explain why the Affordable Care Act is not by any means the final solution to fixing what continues to be for too many Americans a dysfunctional, inequitable and unaffordable health care system. He makes a compelling case for replacing our costly and inefficient multi-payer system with single-payer national health insurance."
--Wendell Potter, former CIGNA executive, senior fellow on health care at the Center for Media and Democracy, and author of Deadly Spin: An Insurance Company Insider Speaks Out On How Corporate PR Is Killing Health Care and Deceiving Americans, and Obamacare: What's In It For Me? What Everyone Needs to Know About the Affordable Care Act.

"Dr. Geyman advocates for single-payer health care with his usual wit, reason, and immaculate documentation. This time he fortifies his points with  personal stories from across the country, describing the wreckage left by the Affordable Care Act. Putting human faces on ObamaCare brings the argument home poignantly. The people telling their stories of our failed health care system could be our friends, our families, and us. The unhappy consequences of ObamaCare touch us all."
--Samuel Metz, M.D., adjunct associate professor of anesthesiology, Oregon Health and Science University, Portland, OR

"Many liberal Democrats supported ObamaCare as a step toward a universal single-payer public health insurance system. As Dr. John Geyman's book makes clear, ObamaCare was instead a leap into the arms of a rapacious private insurance industry that hiked premiums, denied care, cancelled policies, narrowed networks, jacked deductibles, drove doctors to burnout, fueled the rise in medical costs, raided the public treasury, bloated the bureaucracy and corporate profits, privatized Medicare and Medicaid, decreased the quality of care, and left 30 million Americans uninsured. Next time, can we learn from this debacle? Read this book. Then just say no to the private health insurance industry and those who would play their deadly game."
--Russell Mokhiber, Single Payer Action

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