Promises vs. Reality and What Comes Next

by John Geyman, M.D.

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.
Although the ACA has helped many millions of people, it 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 forgo necessary care.

This is a comprehensive, non-partisan, objective look at the ACA almost six years after its passage.
The big question now is: “What next?”

An evidence based approach is presented to assess 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).

How Obamacare is Unsustainable: Why We Need a Single-Payer Solution For All Americans

Confusion and controversy have plagued the Affordable Care Act (ACA or Obamacare) since its
enactment in 2010. Republicans have generally opposed the legislation and attempted to obstruct it
or repeal it altogether. Democrats have tended to support it, defending it against the opposition, but
wary of some of its problems. Patients and families are caught in the middle.

This is the first book to take an evidence-based approach to assessment of the good and bad about
this signature domestic legislation of the Obama presidency after five years of experience. The three
major aims of the ACA—to provide near-universal access to health care, to contain costs and make
health care affordable, and to improve the quality of U.S. health care—are not being met, and the
ACA’s approach to health care reform will not work.

As it fails, the big question is what next? The case is made—on economic, social and moral grounds—
that a single payer improved Medicare-for-All system will best meet the ongoing goals of reform.
This book explains how all Americans can gain universal access to comprehensive health care
paying less than we do now, with more value and less bureaucracy.

ISBN 9781938218026
232 pages

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