Reinventing American Health Care by Ezekiel Emanuel
This book was insightful. It's nice to get a deeper understanding of healthcare after hearing little more than talking points for the last decade.
The book is mostly good. Every chapter covers a broad topic and is broken into subsections for each particular part of that topic. Like there's a healthcare funding chapter which has subsections on Private Insurance, Medicaid, and Medicare (or this is the rough idea anyway).
What I really wanted was a deep dive into the politics surrounding Obamacare. There was definitely discussion of the politics, but it was a pretty minor piece overall.
The book is mostly interested in helping the reader understand how the overall American healthcare system works, with its vast network of hospitals and doctors and health insurance companies and government regulations (and government funded health insurance plans and subsidies).
I really enjoyed learning about the history of American healthcare and past attempts to reform it.
The author is most definitely biased in FAVOR of the Affordable Care Act. They don't try to hide it, which is appreciated. I feel the book is mostly written in an objective style, though.
One thing I really appreciate is learning about all the things the ACA actually did. It was MUCH MORE than just providing healthcare to poor people and guaranteeing healthcare access for the chronically ill. There was lots of reform to help improve the quality of care and drive more people to work in healthcare. And Chain Restaurants tell you how many calories are in each menu item because of the ACA - this being part of its effort to reduce healthcare costs by preventing health issues. (I think it did not go nearly far enough with regulating speech around food being sold. For example, packaged food should say things like "High Salt Content" but instead say "See Nutrition Label for Salt Content". Additionally, in Brazil there ARE labels kind of like "high salt content" and when such labels are required on a food, the food is not allowed to make any other health-related claims. This is a great idea and should be implemented here too. In the U.S. we have things like Spaghettios (which are arguably delicious) that have extremely high levels of both salt AND sugar, then also boast about containing a full serving of vegetables while keeping somewhat quiet about its sugar and salt content.)
One thing they got really wrong in the book though - there is discussion about how the ACA will help bring down health insurance and healthcare costs over the years that follow, and that just frankly didn't happen. Health Insurance premiums and healthcare costs in the U.S. have continued to inflate significantly for many years.
I haven't looked into WHY that is. I'm sure part of it is profits. But I'm also sure that part of it is the guaranteed coverage for the sickest people in the U.S. Emanuel discusses that the majority of healthcare spending goes to the sickest people living with chronic conditions. Obamacare guarantees that those people get healthcare and cannot be penalized for having chronic conditions. Ethically speaking, I think this is a great thing. But economically speaking, I suspect it is not great, and probably plays a pretty big role in the steady increases in our healthcare costs.
Not really covered in the book are how profits affect healthcare costs. There's also no discussion of right-to-repair, which I'm pretty sure impacts healthcare costs (expensive equipment that can't be independently repaired means more money for equipment).
Of course, a 2014 book can't analyze cost increases over the 10 years after it was published. So I really can't fault it for that. BUT that one prediction - about the ACA bringing down healthcare costs - definitely did not come true.
I think it's a good book, and if you're interested in the American Healthcare system, I recommend reading it.
I'm interested to read a more recent book on American Healthcare, especially if this author has written a follow-up, a retrospective.
I did not finish the book. The last part is about the Future of American Healthcare. Frankly, the library book was due for return and that's why I gave up. But I also don't care that much about the future part, compared to the rest. I read everything up to that last part.
One gripe I have with this book is ... almost every section feels like it's giving me about 60% of the details I want. Like on so many sections, I just want more depth and breadth. But it is already a fairly thick book, so I'm glad it restrained itself. I don't think it should have been made longer, and I think the limited space was used well. But its an odd feeling where I wanted more information on almost every single topic, even though I felt it was doing a rather good job.