Health Care Reform: What It Is, Why It's Necessary, How It Works [Paperback]

Jonathan Gruber (Author), Nathan Schreiber (Illustrator)

Book Description

Release date: December 20, 2011

You won’t have to worry about going broke if you get sick.

 

We will start to bring the costs of health care under control.

 

And we will do all this while reducing the federal deficit.

 

That is the promise of the Affordable Care Act. But from the moment President Obama signed the bill into law in 2010, a steady and mounting avalanche of misinformation about the ACA has left a growing majority of Americans confused about what it is, why it’s necessary, and how it works. If you’re one of them, buy this book. From how to tame the twin threats of rising costs and the increasing number of uninsured to why an insurance mandate is good for your health, Health Care Reform dispels false fears by arming you with facts.

Editorial Reviews

Amazon.com Review

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A Look Inside Health Care Reform: What It Is, Why It's Necessary, How It Works
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Review

“Jonathan Gruber, one of the country’s smartest health care minds, has brought the epic struggle of health reform to life. By explaining the challenges in our health care system as well as the benefits of the reform with imagination and verve, he accomplishes what many have tried and failed to do—he makes the case for health reform as an important achievement for the American people.” —Neera Tanden, President of the Center for American Progress

“Having spent years working to make health care work for Americans, Jonathan Gruber has now provided another service: walking everyone through the benefits of the Affordable Care Act reforms so consumers are armed with accessible information. In an age when information is power, Gruber’s book is fun and informative, and it boils down the facts of health care reform for all Americans.” —Senator John Kerry

 

“If you want to learn about health care reform, you can do no better than to learn from the master. Jonathan Gruber shows how health care reform works in a way that everyone can understand. Read this book. You will not regret it.” —David Cutler, Professor, Department of Economics and Kennedy School of Government, Harvard University

 

“Jonathan Gruber’s straightforward explanation of what the Affordable Care Act does and why will help people understand what’s true and what’s false about the health reform law. His message is clear and easy to get: when it comes to health care, we’re all in it together; and, together, we will benefit from making the Affordable Care Act a success.” —Judy Feder, Professor and former Dean, Georgetown Public Policy Institute

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Product Details

• Paperback: 160 pages
• Publisher: Hill and Wang; 1 edition (December 20, 2011)
• Language: English
• ISBN-10: 0809053977
• ISBN-13: 978-0809053971
• Product Dimensions: 10 x 7.1 x 0.6 inches
• Shipping Weight: 9.6 ounces (View shipping rates and policies)
• Average Customer Review: 3.9 out of 5 stars  See all reviews (85 customer reviews)
• Amazon Best Sellers Rank: #12,157 in Books (See Top 100 in Books)
  • #11 in Books > Medical Books > Administration & Medicine Economics > Health Policy
  • #71 in Books > Politics & Social Sciences > Politics & Government > Public Affairs & Policy

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Most Helpful Customer Reviews

48 of 59 people found the following review helpful

4.0 out of 5 stars Needs more substance January 7, 2012

By L. Wilson VINE™ VOICE

Format:Paperback|Amazon Vine™ Review (What's this?)

The book is well worth getting and loaning or finding and borrowing. "Health Care Reform" provides a pretty complete overview of the Affordable Care Act--a subject of much distortion and complaint from the left, the right, and the extreme right.

Jonathan Gruber presents his information in the form of a black and white graphic book. It is easy and quick to read, while gives important information about this new law that is slowly going into effect. He covers all aspects of the law, addresses many of the extreme-right myths, and includes reasons that many of the decisions were made. Throughout the book, he appears to focus on the economics rather than the health aspects, although he frequently includes the fact that people will be healthier.

Gruber was actively involved with the development of both the Massachusetts health care program and the ACA. He is able to write from the position of knowledge of both the economics and the politics involved. His conclusions are overall optimistic: The ACA will improve the health of Americans and keep down the cost.

Gruber is pretty optimistic about the further development of the law. He "has confidence" that state planning will work. In states like Wisconsin, though, the governor is refusing to do any planning in hopes that it won't work and he and his cronies can blame someone else for it. Gruber mentions this kind of situation, but there is little he can do to address it in a book with this focus and size.

Unfortunately, I have a few complaints. First, his description of the crisis is pretty extreme. The health care crisis is very serious, but it is not as extreme as some people have painted it. On the other hand, the opposition smiles and says, "Everything is perfect," so maybe the overstating is necessary.

Second, lumping Medicare and Medicaid together overlooks a lot of important differences in the programs. E.g., Medicaid is means based and Medicare is age based. Medicaid payments are revenue based. Medicare is self-funded by a separate payroll tax.

Third, he hit a real sore point with me. One of the big complaints about the cost of health care is people staying in the hospital too long and getting too many tests. In my case, I had a successful operation. I was sent home the next day early and was not given a $250 test. The result was another visit to the operating room ten days later for $10,000 and the successful operation turned into a personal disaster. This doesn't apply to everyone, but the important thing is to treat each patient with what they need--and many of us don't actually need that extra test. (Some of the tests are definitely overpriced. My doctor gives me a $25.00 test each time I go in, but the insurance company only pays a contracted $2.00 for it.)

This kind of generality about hospitals, doctors, etc., is pretty common and annoying, but, after all, the book is only about 150 pages.

Gruber's "Health Care Reform" packs more accurate and complete information than I have seen anywhere else into a very readable and re-readable form. Definitely worth getting hold of and worth sharing.

31 of 40 people found the following review helpful

4.0 out of 5 stars Interesting and Informative Book About the Health Care Reform Law January 1, 2012

By Frederick S. Goethel VINE™ VOICE

Format:Paperback|Amazon Vine™ Review (What's this?)

The primary author of this book is a Professor of Economics at MIT and was on the team that helped develop the model for health care reform in Massachusetts, so he has more than a little credibility on the subject....in fact, he is an expert. In this book he explains, in relatively simple language, the facts of the Patient Protection and Affordable Care Act which was passed by Congress several years ago and which is scheduled to be in full effect by 2014.

At first I was a little taken aback when I opened the book and discovered it had been written in a comic book format, but as I read on, I realized that the author was doing a great job of explaining how all of this works and was doing so in a simple fashion that was easy to understand. He works to piece together all of the various parts of the law into a seamless story, and along the way he debunks many of the myths about the Act, such as "death panels" and other fear mongering political stunts that were used to confuse people. When broken down in this way, it turns out the law is fairly simple to understand.

The author takes a bipartisan look at the law and points out that many of the provision were things that conservatives have been trying to pass into law for years. He also does a great job of explaining why you cannot take out individual provisions from the law without reducing, if not outright defeating, the ultimate goals of the law.

The two downsides I see to this book are the comic format, which may turn people off, and the simple nature of the explanation. While hitting all the high notes, some people may believe it is impossible to truly present a 2,000 page law adequately in this short of a space and in such simple language.

I would highly recommend this book to all. There is a lot of confusion about the new law, and this will help people understand it. In addition the author discusses the reason the law in needed and how it will help individuals and companies. I doubt that people who are dead set against the law will be persuaded, but they might learn a lot from this simple comic book.

58 of 77 people found the following review helpful

5.0 out of 5 stars The advent of the excellent short visual book! December 21, 2011

By Gaetan Lion TOP 1000 REVIEWER

Format:Paperback|Amazon Vine™ Review (What's this?)

This is a daring experiment consisting in treating a complex subject and distilling it to its essential information through a short cartoon medium. After reading this book slowly in just an hour and a half I am convinced this experiment is onto something.

The experiment worked for several reasons. First, Jonathan Gruber, the author is the real deal. As an MIT economics professor specializing in health care policy no one understands this topic any better. Additionally, Gruber expresses himself in clear and simple everyday language that is appropriate for the cartoon medium. He also uses an apolitical tone acknowledging fully the reservations of both the left and the right. Second, the illustrator, Nathan Schreiber, is very good. The cartoon is not too cute. It is just right.

In just a little bit over an hour, you will absorb most of what you need to know about the Patient Protection and Affordable Care Act (ACA). This short book makes you understand why the existing system is costly, unsustainable, broken, and dangerous. Every year the majority of individual bankruptcies are caused by medical related expenses (running probably at one million individual bankruptcies a year). And, over 20,000 die a year because of inadequate access to health care. Defending the current system can only be explained as an act of ignorance. Similarly, screaming against the ACA as many have is also an act of ignorance. Gruber addresses all the screaming on either side of the aisle and simply states, Ok let's cool down here is what ACA really is and is not.

Gruber explains at length the basic trade off. Its foundation is the reviled mandate. If you want a system that attempts to cover all individuals and that is effective and reliable (no denial for preexisting condition, no annual and lifetime limits, no policy cancellation, no coverage denial) you need a mandate. It is simple if the insurance industry can't reduce their claim risk, they need to insure the whole population. With no mandate, the insurance industry would become insolvent due to the negative self-selected bias (only the sick and the old seek insurance). If people understood this straight forward concept, support for the ACA would not be an issue. Hopefully, Gruber's book will be successful and contribute to the masses understanding why the mandate is necessary.

Gruber acknowledges the mandate will be subject to a Supreme Court decision (by June 2012). He states that even if the mandate is deemed unconstitutional, the remainder of the ACA would proceed. But, he states that based on CBO's estimates it will be far less successful than otherwise. Only half as many uninsured would get covered. Premium for individual health plans will be 20% higher. Employer provided insurance will fall twice as fast. Health care costs will run much higher. In other words, the ACA without a mandate (even though still better than the existing system) will be far less effective than ACA with a mandate.

This short book is surprisingly detailed oriented. Gruber covers the parameters of the mandate (MAX ($95 or 1% of income) in 2014 rising to MAX ($695 or 2.5% or income in 2016). Similarly, businesses with more than 50 employees will incur a penalty of $2000 per employees if they do not provide health care. Gruber states that the penalty is only 1/3 of the cost of covering an employee. Gruber covers many other technical details that by the end of the book, you have an encompassing knowledge of the ACA.

This book is also really interesting because of what the author has done. Gruber was the main architect of Massachusetts health care (dubbed Romneycare). He also was an important advisor to Obama in the design of the ACA. Within the book, Gruber shows that the ACA was designed after Romneycare. Gruber states explicitly that Romneycare also has a mandate (penalty of $240 to $1,100 per annum). This fact contradicts Romney's Powerpoint where he states the Massachusetts plan does not have a mandate. Romney states that the ACA is a government over reach while his Massachusetts plan is not. Meanwhile, per Gruber there are no clear distinctions in structure between the two plans. So, when Romney campaigns on the pledge that one of the first things he would do is dismantle the ACA; it is inconsistent given he has implemented a preceding plan almost identical to the ACA.

In summary, this is an excellent book if you want to understand the ACA and spend not much more than an entertaining hour on the subject.