The Dysfunctional Politics of the Affordable Care Act


Book Description

While analyzing the contentious debate over health care reform, this study also challenges the argument that treating medical patients like shoppers can significantly reduce health expenditures. This work focuses on the politics surrounding the Affordable Care Act (ACA), explaining how and why supporters and opponents have approached the issue as they have since the act's passage in 2010. The first book to systematically examine public knowledge of the ACA across time, it also documents how that knowledge has remained essentially static since 2010, despite the importance of health-policy reform to every American. The early chapters explain why congressional Democrats designed the Affordable Care Act of 2010 as they did, clarifies some of the consequences of the act's features, and examines why Republicans have fought the implementation of the law so fiercely. The study then looks at how the intersection of economics and politics applies to the ACA. Finally, the book details what the public knows--and doesn't know--about the law and discusses the prospects for citizens gaining the knowledge they should have about the overall issue of health-policy reform.




The Dysfunctional Politics of the Affordable Care Act


Book Description

While analyzing the contentious debate over health care reform, this much-needed study also challenges the argument that treating medical patients like shoppers can significantly reduce health expenditures. This revealing work focuses on the politics surrounding the Affordable Care Act (ACA), explaining how and why supporters and opponents have approached the issue as they have since the act's passage in 2010. The first book to systematically examine public knowledge of the ACA across time, it also documents how that knowledge has remained essentially static since 2010, despite the importance of health-policy reform to every American. An important book for anyone concerned about the skyrocketing costs of health care in the United States, the work accomplishes three main tasks intended to help readers better understand one of the most important policy challenges of our time. The early chapters explain why congressional Democrats designed the Affordable Care Act of 2010 as they did, clarifies some of the consequences of the act's features, and examines why Republicans have fought the implementation of the law so fiercely. The study then looks at how the intersection of economics and politics applies to the ACA. Finally, the book details what the public knows-and doesn't know-about the law and discusses the prospects for citizens gaining the knowledge they should have about the overall issue of health-policy reform.




America's Bitter Pill


Book Description

NEW YORK TIMES BESTSELLER • A NEW YORK TIMES NOTABLE BOOK • “A tour de force . . . a comprehensive and suitably furious guide to the political landscape of American healthcare . . . persuasive, shocking.”—The New York Times America’s Bitter Pill is Steven Brill’s acclaimed book on how the Affordable Care Act, or Obamacare, was written, how it is being implemented, and, most important, how it is changing—and failing to change—the rampant abuses in the healthcare industry. It’s a fly-on-the-wall account of the titanic fight to pass a 961-page law aimed at fixing America’s largest, most dysfunctional industry. It’s a penetrating chronicle of how the profiteering that Brill first identified in his trailblazing Time magazine cover story continues, despite Obamacare. And it is the first complete, inside account of how President Obama persevered to push through the law, but then failed to deal with the staff incompetence and turf wars that crippled its implementation. But by chance America’s Bitter Pill ends up being much more—because as Brill was completing this book, he had to undergo urgent open-heart surgery. Thus, this also becomes the story of how one patient who thinks he knows everything about healthcare “policy” rethinks it from a hospital gurney—and combines that insight with his brilliant reporting. The result: a surprising new vision of how we can fix American healthcare so that it stops draining the bank accounts of our families and our businesses, and the federal treasury. Praise for America’s Bitter Pill “An energetic, picaresque, narrative explanation of much of what has happened in the last seven years of health policy . . . [Brill] has pulled off something extraordinary.”—The New York Times Book Review “A thunderous indictment of what Brill refers to as the ‘toxicity of our profiteer-dominated healthcare system.’ ”—Los Angeles Times “A sweeping and spirited new book [that] chronicles the surprisingly juicy tale of reform.”—The Daily Beast “One of the most important books of our time.”—Walter Isaacson “Superb . . . Brill has achieved the seemingly impossible—written an exciting book about the American health system.”—The New York Review of Books




Obamacare Wars


Book Description

Not five minutes after the Affordable Care Act (ACA) was signed into law, in March 2010, Virginia’s attorney general was suing to stop it. And yet, the ACA rolled out, in infamously bumpy fashion, and rolled on, fought and defended at every turn—despite President Obama’s claim, in 2014, that its proponents and opponents could finally “stop fighting old political battles that keep us gridlocked.” But not only would the battles not stop, as Obamacare Wars makes acutely clear, they spread from Washington, DC, to a variety of new arenas. The first thorough account of the implementation of the ACA, this book reveals the fissures the act exposed in the American federal system. Obamacare Wars shows how the law’s intergovernmental structure, which entails the participation of both the federal government and the states, has deeply shaped the politics of implementation. Focusing on the creation of insurance exchanges, the expansion of Medicaid, and execution of regulatory reforms, Daniel Béland, Philip Rocco, and Alex Waddan examine how opponents of the ACA fought back against its implementation. They also explain why opponents of the law were successful in some efforts and not in others—and not necessarily in a seemingly predictable red vs. blue pattern. Their work identifies the role of policy legacies, institutional fragmentation, and public sentiments in each instance as states grappled with new institutions, as in the case of the exchanges, or existing structures, in Medicaid and regulatory reform. Looking broadly at national trends and specifically at the experience of individual states, Obamacare Wars brings much-needed clarity to highly controversial but little-understood aspects of the Affordable Care Act’s odyssey, with implications for how we understand the future trajectory of health reform, as well as the multiple forms of federalism in American politics.




The Ten Year War


Book Description

Jonathan Cohn's The Ten Year War is the definitive account of the battle over Obamacare, based on interviews with sources who were in the room, from one of the nation's foremost healthcare journalists. The Affordable Care Act, better known as “Obamacare,” was the most sweeping and consequential piece of legislation of the last half century. It has touched nearly every American in one way or another, for better or worse, and become the defining political fight of our time. In The Ten Year War, veteran journalist Jonathan Cohn offers the compelling, authoritative history of how the law came to be, why it looks like it does, and what it’s meant for average Americans. Drawn from hundreds of hours of interviews, plus private diaries, emails and memos, The Ten Year War takes readers to Capitol Hill and to town hall meetings, inside the West Wing and, eventually, into Trump Tower, as the nation's most powerful leaders try to reconcile pragmatism and idealism, self-interest and the public good, and ultimately two very different visions for what the country should look like. At the heart of the book is the decades-old argument over what’s wrong with American health care and how to fix it. But the battle over healthcare was always about more than policy. The Ten Year War offers a deeper examination of how our governing institutions, the media and the two parties have evolved, and the dysfunction those changes have left in their wake.




An American Sickness


Book Description

A New York Times bestseller/Washington Post Notable Book of 2017/NPR Best Books of 2017/Wall Street Journal Best Books of 2017 "This book will serve as the definitive guide to the past and future of health care in America.”—Siddhartha Mukherjee, Pulitzer Prize-winning author of The Emperor of All Maladies and The Gene At a moment of drastic political upheaval, An American Sickness is a shocking investigation into our dysfunctional healthcare system - and offers practical solutions to its myriad problems. In these troubled times, perhaps no institution has unraveled more quickly and more completely than American medicine. In only a few decades, the medical system has been overrun by organizations seeking to exploit for profit the trust that vulnerable and sick Americans place in their healthcare. Our politicians have proven themselves either unwilling or incapable of reining in the increasingly outrageous costs faced by patients, and market-based solutions only seem to funnel larger and larger sums of our money into the hands of corporations. Impossibly high insurance premiums and inexplicably large bills have become facts of life; fatalism has set in. Very quickly Americans have been made to accept paying more for less. How did things get so bad so fast? Breaking down this monolithic business into the individual industries—the hospitals, doctors, insurance companies, and drug manufacturers—that together constitute our healthcare system, Rosenthal exposes the recent evolution of American medicine as never before. How did healthcare, the caring endeavor, become healthcare, the highly profitable industry? Hospital systems, which are managed by business executives, behave like predatory lenders, hounding patients and seizing their homes. Research charities are in bed with big pharmaceutical companies, which surreptitiously profit from the donations made by working people. Patients receive bills in code, from entrepreneurial doctors they never even saw. The system is in tatters, but we can fight back. Dr. Elisabeth Rosenthal doesn't just explain the symptoms, she diagnoses and treats the disease itself. In clear and practical terms, she spells out exactly how to decode medical doublespeak, avoid the pitfalls of the pharmaceuticals racket, and get the care you and your family deserve. She takes you inside the doctor-patient relationship and to hospital C-suites, explaining step-by-step the workings of a system badly lacking transparency. This is about what we can do, as individual patients, both to navigate the maze that is American healthcare and also to demand far-reaching reform. An American Sickness is the frontline defense against a healthcare system that no longer has our well-being at heart.




The Affordable Care Act


Book Description

The Patient Protection and Affordable Care Act (ACA) was designed to increase health insurance quality and affordability, lower the uninsured rate by expanding insurance coverage, and reduce the costs of healthcare overall. Along with sweeping change came sweeping criticisms and issues. This book explores the pros and cons of the Affordable Care Act, and explains who benefits from the ACA. Readers will learn how the economy is affected by the ACA, and the impact of the ACA rollout.




Controversies in American Federalism and Public Policy


Book Description

This interdisciplinary collection presents a scholarly treatment of how the constitutional politics of federalism affect governments and citizens, offering an accessible yet comprehensive analysis of the U.S. Supreme Court’s federalism jurisprudence and its effect on the development of national and state policies in key areas of constitutional jurisprudence. The contributors address the impact that Supreme Court federalism precedents have in setting the parameters of national law and policies that the states are often bound to respect under constitutional law, including those that relate to the scope and application of gun rights, LGBT freedoms, health care administration, anti-terrorism initiatives, capital punishment, immigration and environmental regulation, the legalization of marijuana and voting rights. Uniting scholarship in law, political science, criminology, and public administration, the chapters study the themes, principles, and politics that traditionally have been at the center of federalism research across different academic disciplines. They look at the origins, nature and effect of dual and cooperative federalism, presidential powers and administrative regulation, state sovereignty and states’ rights, judicial federalism and the advocacy of organized interests.




Public Opinion and the Political Economy of Education Policy around the World


Book Description

Comparative analyses of the influence of public opinion on education policy in developed countries. Although research has suggested a variety of changes to education policy that have the potential to improve educational outcomes, politicians are often reluctant to implement such evidence-based reforms. Public opinion and pressure by interest groups would seem to have a greater role in shaping education policy than insights drawn from empirical data. The construction of a comparative political economy of education that seeks to explain policy differences among nations is long overdue. This book offers the first comparative inventory and analysis of public opinion and education in developed countries, drawing on data primarily from Europe and the United States.




The American Congress


Book Description

This volume thoroughly examines the operations and politics of the U.S. Congress. It guides readers to their own assessment of congressional politics and provides them with the basis for future reading and study of the subject. The American Congress: A Reference Handbook covers Congress from its inception to the present day, discussing the constitutional functions of Congress and how they have evolved over time. It presents a detailed discussion of 15 problems with which Congress copes, some associated concerns with those problems, and how they might be resolved. The book opens with a brief history of Congress and how it has changed over time. It discusses a series of problems and concerns, and proposed solutions to those problems. It also comprises nine original essays by other scholars and persons involved in congressional politics as well as profiles of the major organizations and actors involved. Data and documents and a detailed chronology of Congress from 1789 to 2018 allow readers to situate significant legislation within the history of Congress, while an annotated list of sources—the major books and scholarly journals concerned with Congress in addition to a number of feature-length films and videos—provide readers with vetted resources for further study.