Public Affairs
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Reinventing American Health Care
How the Affordable Care Act will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System


The definitive story of American health care today—its causes, consequences, and confusions

In March 2010, the Affordable Care Act was signed into law. It was the most extensive reform of America’s health care system since at least the creation of Medicare in 1965, and maybe ever. The ACA was controversial and highly political, and the law faced legal challenges reaching all the way to the Supreme Court; it even precipitated a government shutdown. It was a signature piece of legislation for President Obama’s first term, and also a ball and chain for his second.

Ezekiel J. Emanuel, a professor of medical ethics and health policy at the University of Pennsylvania who also served as a special adviser to the White House on health care reform, has written a brilliant diagnostic explanation of why health care in America has become such a divisive social issue, how money and medicine have their own—quite distinct—American story, and why reform has bedeviled presidents of the left and right for more than one hundred years.
Emanuel also explains exactly how the ACA reforms are reshaping the health care system now. He forecasts the future, identifying six mega trends in health that will determine the market for health care to 2020 and beyond. His predictions are bold, provocative, and uniquely well-informed. Health care—one of America’s largest employment sectors, with an economy the size of the GDP of France—has never had a more comprehensive or authoritative interpreter.

about Ezekiel Emanuel

  • Ezekiel J. Emanuel is vice provost for global initiatives and chair of the department of medical ethics and health policy at the University of Pennsylvania. From January 2009 to January 2011, he was a special adviser on health care reform to the White House. He is the author or editor of ten books and over 250 scientific articles. He is currently a senior fellow at the Center for American Progress, a columnist for the New York Times, a regular contributor to the Wall Street Journal, contributing editor at The New Republic, and appears regularly on television, including Morning Joe, Real Time with Bill Maher, Hardball with Chris Matthews, and the Rachel Maddow Show.


“For Americans poisoned by nefarious medical insurance companies and a G.O.P. dying to gut Obamacare, I prescribe Ezekiel Emanuel’s Reinventing American Health Care (PublicAffairs) to clarify how the Affordable Care Act can rehabilitate our nauseatingly unjust, grossly expensive, and senselessly complicated health-care system. My personal recommendation? Lay off the toxic propaganda.”—Vanity Fair

“Whether you agree with his conclusions or not, they’re well argued, and he has marshaled an impressive amount of information.”—Washington Post

“Infused with diagrams, charts, and tables, this book is informative, thought-provoking, and immensely important. Given his role in the program, and as is reflected in the subtitle of the book, Emanuel clearly wants to persuade, but he also wants to explain. And because he was an insider — and proves himself a gifted writer — he makes an able guide to the complexities of the landmark legislation… Clearly, if Obamacare is to fulfill its promise there will need to be significant changes and that will require collaboration among citizens, health care professionals, scholars, and lawmakers from across the political spectrum. And the only way this can happen is if people understand what exactly is at stake. ‘Reinventing American Health Care’ spells this out clearly, and by doing so, lays the foundation for this kind of collaboration to occur.”—Dennis Rosen, Boston Globe

“The facts and history that Emanuel lays out would be useful to anyone involved in the debate over health care, no matter what their point of view is.”—250Words.com

“With this book, Zeke Emanuel has done the country an immense service. He does the impossible—explain the dysfunctional American health care system—and then takes it one better. For here he also makes the hard-eyed case for understanding that the passage of health reform—of Obamacare—has set us on a path for a health system that works. Our system has left millions without needed care, bankrupt, or both, and tied the fate of their health to where they work. This book explains how we got in this fix, how we will get out of it—and even more boldly, when. If you wanted to read one book to understand health care, this is the one you want.” —Atul Gawande, surgeon, staff writer for The New Yorker, and author of The Checklist Manifesto

“There are thoughtful doctors, savvy policy makers and profound scholars of morality. Zeke Emanuel is the only person in America who is all three. That makes him the right person to write the definitive primer on health care in America. It should be read by anyone who wants to understand what may be the most important set of domestic issues facing America.” —Lawrence H. Summers, former Secretary of the Treasury of the United States, & President Emeritus and Charles W. Eliot University Professor of Harvard University

“Zeke Emanuel has written a book that tells people interested health care policy what they need to know but all too often do not. He brings together a staggering variety of information, never before available in one place, on economics, medicine, legislative history, governmental operations, politics, and the gory, boring, and surpassingly important issue of implementation. No single book can tell one all one needs to know about the most complex health care system in the world, but this one comes very close indeed.” —Henry J. Aaron, the Bruce and Virginia MacLaury Senior Fellow in the Economic Studies program at the Brookings Institution

“The author, who serves as a special White House adviser on health care refo

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