Thursday, February 5, 2015

John Geyman's timely book on ACA and single payer

Copernicus Healthcare
January, 2015

How Obamacare Is Unsustainable:
Why We Need a Single-Payer Solution for All Americans
By John Geyman, M.D.

As we all know, the intense debate over Obamacare, or the Affordable
Care Act (ACA), is a polarizing issue that sharply divides political
parties and the public. Confusion reigns over its benefits, problems and
prospects as claims and counterclaims fill press and media coverage.

This book is an attempt to make sense out of all of this - to cut
through the rhetoric, disinformation and myths to assess what is good
and bad about the ACA, and to ask whether or not it can remedy our
system's four main problems - uncontrolled costs, unaffordability,
barriers to access, and mediocre, often poor quality of care.

In Part One, we will briefly trace historical roots of various reform
attempts over the years, and summarize some of the major trends that
have changed the delivery system, professional roles and values, the
ethics of health care, and the role of government vs. the private
sector. In Part Two, we will compare the ACA's promises with realities
of what it has accomplished, examine its initial outcomes on access,
cost containment, affordability and quality of care, ask whether its
flaws can be fixed with a private insurance industry, and point out the
lessons that we can already take away from the first five years of the
law. In Part Three, we will discuss the many myths that are perpetuated
by opponents of single-payer national health insurance (NHI) and show
how that approach stands ready to deal directly with what has become a
national disgrace - our increasingly fragmented and cruel health care
system that serves corporate interests at the expense of ordinary
Americans. We will make the case for NHI in three ways - economic,
social/political, and moral. Most other advanced countries around the
world came to this conclusion many years ago.

Why this book now? With the 2014 midterm elections behind us, divisions
between the parties are even more polarized. The future of health care
is even more uncertain. The 2016 election cycle is already underway, and
both parties have to confront the failures of yet another incremental
attempt to reform our so-called health care system. We have a short year
and a half to re-assess where we are and try once again to get health
care reform right. As much of the public knows all too well, the stakes
get higher every day.

"How Obamacare Is Unsustainable" can be purchased through PNHP for
$15.00, at the following link. It is also available through
and for $18.95.


Comment by Don McCanne

John Geyman has been a prolific writer of books describing the major
deficiencies in health care in the United States, but "How Obamacare Is
Unsustainable" is set apart from the others for a couple of important
reasons. He explains what has been wrong with our five year experiment
in reform and what we can do about it, and, especially pertinent, it is
timed to coincide with a moment in history in which there will be an
intense national dialogue recognizing the health care failures of the
past and present, with a demand for political solutions as we enter the
season of the 2016 presidential election.

Just today, Sen. Burr, Sen. Hatch and Rep. Upton released a nine page
report being characterized as the Republican response to Obamacare
(though Speaker Boehner has requested another, likely similar proposal
from a House team that includes Rep. Upton). Unfortunately, the
Burr/Hatch/Upton response is highly partisan and thus gets most of the
policy wrong. Although the Affordable Care Act was conceived as a
non-partisan solution, it too became partisan as the politics shifted
from a largely right-wing concept advanced by Democrats (non-partisan)
to an exclusively Democrat-endorsed proposal (highly partisan). In the
turmoil, the result ended up being the most expensive model of reform,
yet it contained terribly flawed policies that fall intolerably short of
universality, affordability, accessibility, efficiency and equity. Both
the Democrats and the Republicans are wrong.

As we enter the pending national dialogue on reform we need to move the
rhetoric from partisan sniping to informed discussions of policy. We
know where Congress lies in the highly-polarized partisan divide, but
what about the nation?

According to a January 2015 Gallup poll, 42% of voters are Independents,
29% are Republicans, and 28% are Democrats. Thus a plurality is

According to that same Gallup poll, 45% of Independents support getting
their insurance "through an expanded, universal form of Medicare." To no
surprise, 79% of Democrats also support universal Medicare, but, of
great importance, 23% of Republicans do as well. When people understand
policy, the partisan polarization diminishes.

At this time in history, it is imperative that all solutions be on the
table, including those that give up on comprehensive reform
(Burr/Hatch/Upton), those that perpetuate unacceptable mediocrity (the
Affordable Care Act), and those that would actually achieve the goals
that a large majority of Americans support (single payer, improved
Medicare for all).

This is why John Geyman's book is so timely. It is a book on optimal
policy. It can be contrasted with today's partisan release on the
Republican answer to Obamacare. Their nine page proposal can be accessed
at the following link:

Partisan politics has not served us well with the Democrats giving us
overpriced and mediocre reform and the Republicans proposing to further
expose patients to the perverse dysfunctions of the market. Maybe
Independents can help us stamp out partisanship and instead become
serious about doing what is right for the nation.

Right now we have a chance to change history. We should make widely
available John Geyman's book based on sound, effective policy - just
what the nation desperately needs.

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