Unaffordable: American Healthcare from Johnson to Trump [Hardcover]

Written for nonexperts, this is a brisk, engaging history of American healthcare from the advent of Medicare and Medicaid in the 1960s to the impact of the Affordable Care Act in the 2010s. Step by step, Jonathan Engel shows how we arrived at our present convoluted situation, where generic drugs prices can jump 1,000 percent in a day and primary care physicians can lose 20 percent of their income at the stroke of a Congressional pen.

Unaffordablecovers, in a conversational style punctuated by apt examples, topics ranging from health insurance, pharmaceutical pricing, and physician training to health maintenance organizations and hospital networks. Along the way, Engel introduces approaches that other nations have taken in organizing and paying for healthcare and offers insights on ethical quandaries around end-of-life decisions, neonatal care, life-sustaining treatments, and the limits of our ability to define death. While describing the political origins of many of the federal and state laws that govern our healthcare system today, he never loses sight of the impact that healthcare delivery has on our wallets and on the balance sheets of hospitals, doctors' offices, government agencies, and private companies.

Written for nonexperts, this is a brisk and engaging history of the American healthcare system from the advent of Medicare and Medicaid in the 1960s to the impact of the Affordable Care Act in the 2010s. Covering topics as varied as health insurance, pharmaceutical pricing, government policies, physician training, medical ethics, and healthcare in other countries, it explains how healthcare in the United States has been organized, managed, delivered, and paid for.

Engel's clear storyline and simple (but not simplistic) analysis make sense of a topic of mind-boggling complexity. Invaluable. David Herzberg, author ofHappy Pills in America

A comprehensive, readable, balanced examination of the costs ofl#2