Based on over 30 years of study, this book is for people who want to understand why the health care system is so important for us, how it really works, what caused the problems that have grown to monumental proportions in recent decades, how we can solve them, and why we have failed to overcome the problems for so many years. It describes six elements that are critical to a successful reform plan and how various compromises with those elements can affect what a new law will produce. It will also help the reader understand why the new law will make substantial progress toward achieving some reform goals, but leaves more to be done.
The new law will require that almost everyone have insurance, create an insurance market for those without employer-based coverage, establish minimum standards for coverage, and subsidize those who cannot afford available policies. But the book’s title reflects the fact that, even though the newly enacted law includes the most substantial reforms since adoption of Medicare and Medicaid in the 1960s, reform is still a work in progress. Millions of Americans will continue to have access problems and, as a nation, we will still pay too much and get too little from a system that will continue to get worse — primarily because it will not have strong incentives for providers to make it better. The book will help readers understand the new law and draw their own conclusions.
