This is an excellent book for one wanting a clear, relatively short history of the Medicaid program and how it impacts the individual states as well as the federal government. My only complaint is that the author unnecessarily taints her narrative with an obvious bias against big business which she supports, in each section or chapter, largely with one or a few anecdotal examples or a governmental study of questionable utility. As a former healthcare executive with over twenty years experience, I know that many of her generalizations about the nursing home, hospital, managed care and physician segments of the healthcare market are either incorrect or don't tell the complete story, which would change her conclusions. This could have been rectified by learning more about the industries or, best of all, leaving the bias out altogether. In fact, the book would have rated a five star if the author would have left out the bashing, general statements altogether. For instance, she could have said that the nursing home industry spent "x" amount for lobbyists or that the hospital industry appears to earn profits even on Medicaid patients without saying, in effect, that our healthcare crisis is caused by a bunch of greedy big businessmen which is, obviously, an over simplification. Just give us the facts and the readers can draw their own conclusions. This would make the book a pleasure to read in twenty-five years, rather than date it by its polemics.
Once again, a book worth reading! I don't usually write reviews. However, it bothers me when a book this good is unnecessarily blemished by high-level rhetoric that distracts any reader with a high level of knowledge of the industry she discusses. I hope the author continues to explore the health care industry's history, but can write with a more objective viewpoint.