Inside National Health Reform

Inside National Health Reform

Inside National Health Reform

Inside National Health Reform

Synopsis

This indispensable guide to the Affordable Care Act, our new national health care law, lends an insider's deep understanding of policy to a lively and absorbing account of the extraordinary--and extraordinarily ambitious--legislative effort to reform the nation's health care system. Dr. John E. McDonough, DPH, a health policy expert who served as an advisor to the late Senator Edward Kennedy, provides a vivid picture of the intense effort required to bring this legislation into law. McDonough clearly explains the ACA's inner workings, revealing the rich landscape of the issues, policies, and controversies embedded in the law yet unknown to most Americans. In his account of these historic events, McDonough takes us through the process from the 2008 presidential campaign to the moment in 2010 when President Obama signed the bill into law. At a time when the nation is taking a second look at the ACA, Inside National Health Reform provides the essential information for Americans to make informed judgments about this landmark law.

Excerpt

The Affordable Care Act (ACA), signed into law by President Barack Obama in March 2010, is a landmark law in the history of health and social welfare policy in the United States, on the same level as the Social Security Act of 1935 and the Medicare and Medicaid Act of 1965. This is true whether one regards the law as monumentally good or monumentally bad. Few federal laws in U.S. history approach it in terms of scope, breadth, and ambition.

Unlike its 1935 and 1965 peers, the ACA is also monumentally complex and challenging to comprehend. The law’s ten titles address nearly every aspect of the U.S. health care system, sometimes clarifying, improving, and simplifying, and other times adding further layers of complexity. The ACA’s complexity reflects that of the American health care system, a diverse, decentralized, and poorly understood behemoth. No system in any other advanced nation is so fractured and difficult to understand, whether in financing or the delivery of medical services. The system’s sizable and ever-growing intricacy is the reason that comprehensive legislative reform of the system is challenging to explain and to understand.

I wrote this book to help Americans better understand what the ACA really is, what it contains, what it seeks to accomplish, how it is structured, how its financing works, and how so many of its diverse elements came to be. In the wake of the law’s signing and the congressional elections of November 2010, many Americans want to revisit the actions of the Obama administration and the Democratic majorities in the U.S. Senate and House that passed the law. Some want to repeal it in toto while others want various provisions altered or eliminated. Others hope to see the law implemented as enacted in whole or in major part or even expanded beyond its current scope. Still more find themselves perplexed and uncertain what to believe and how to regard the law. All perspectives can benefit from a . . .

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