A citizen's guide to America's most debated policy-in-waiting
There are few issues as consequential in the lives of Americans as healthcare--and few issues more politically vexing. Every single American will interact with the healthcare system at some point in their lives, and most people will find that interaction less than satisfactory. And yet for every dollar spent in our economy, 18 cents go to healthcare. What are we paying for, exactly?
Healthcare policy is notoriously complex, but what Americans want is simple: good healthcare that's easy to use and doesn't break the bank. Polls show that a majority of Americans want the government to provide universal health coverage to all Americans.
What's less clear is how to get there.
Medicare for All is the leading proposal to achieve universal health coverage in America. But what is it exactly? How would it work? More importantly, is it practical or practicable?
This book goes beyond partisan talking points to offer a serious examination of how Medicare for All would transform the way we give, receive, and pay for healthcare in America.
Dr. Abdul El-Sayed is a physician, epidemiologist, public health expert, and progressive activist. He was appointed health director of Detroit at 30 years old. He's a former professor at Columbia University's Mailman School of Public Health. He holds a doctorate in public health from Oxford University as a Rhodes Scholar, and a medical degree from Columbia University.
I have gone through two graduate public health programs and have worked for both a large insurance provider group and an association that represents dental providers. NEVER have I seen a text that so masterfully explains the public health crisis of underinsurance and the opportunity to reform our healthcare policies to improve the lives of populations in the United States. Separated into three sections, Dr. El Seyed and Dr. Johnson explain the the key elements of health systems in the U.S. and why are are not working for all Americans and the history of healthcare legislation, the fundamental concepts of Medicare for All policies, and finally the politics that are at play with moving forward healthcare reform. I recommend this citizen's guide to everyone interested in learning more about our healthcare systems - but especially those that work in the healthcare sector.
Short and to the point, this citizen's guide to Medicare for All is the perfect book to buy and read, then lend or give away to others. While I have spent a considerable amount of time reading articles and one other book about this topic previously, the authors manage to cram in enough different angles of the policy and enough facts and sources to make it well worth the read. Regardless of how much new information one learns here, the value in this exploration really lies in its simple yet powerful rhetoric, its basic dissection of our broken system that works for so few, and its ubiquitous underlying humanity. This is a fight worth fighting.
Incredibly clear and thoughtful discussion of a complex topic! Great mix of personal stories, history, and policy. Highly recommend to anyone interested in learning about America’s healthcare system and the potential for Medicare for All to make “health as a human right” a reality.
Really insightful and comprehensive… really enjoyed the discussion of the monopolization of the pharmaceutical industry and also liked the discussion of the sociopolitical barriers to healthcare
A quick-reading primer that is singularly focused on Medicare for all plan. I would have liked to read more about Medicare for America or other alternatives currently being discussed.
This book was extremely good. I was looking forward to it for a long time. A book on "Medicare-For-All" is a godsend. Millions of Americans don't have health insurance, or lack good insurance, including myself. I read this book and added it to my bookclub to raise awareness on the topic, and hope more people read it. I am eager to see even more members of Congress who are on board with Medicare For All. Let's make this a reality! This book is a must-read! I am tired of Americans running a go-fund-me page just to pay for medical bills. This is freaking ridiculous. We need Medicare-For-All ASAP!
Prepping for Your Career: Training Programs and Certifications Breaking into the billing and coding sector needs more than a wink and a grin (though I’m sure yours are great). It involves instruction from respectable universities and certification from a reputable credentialing agency for medical coding services. The next parts provide the details. An overview of your certification possibilities To land a job as a biller and coder, you must get certified by a respectable credentialing body such as the American Health Information Management Association (AHIMA) or the AAPC (previously known as the American Academy of Professional Coders) (formerly known as the American Academy of Professional Coders). In Chapter 7, I give you everything you need to know about these groups. Here’s a basic overview: ✓ The AAPC is the certifying body that gives Certified Professional Coder (CPC) qualifications. The AAPC course focuses on physician offices and outpatient hospital-based coding. \s ✓ The AHIMA coding certifications — Correct Coding Specialist (CCS) and Certified Coding Associate (CCA) — are intended to certify the coder who has demonstrated proficiency in inpatient and outpatient hospital-based coding, while the Correct Coding Specialist Physician-Based (CCS-P) is, as its name indicates, for coders who work for individual physicians. All sorts of other specialty certifications are also available, which you may read more about in Chapter 10. To determine whether certification — AHIMA or AAPC — best fits your career ambitions, first think about the type of training program you want. Second, assess your long-term job ambitions. What kind of medical billing and coding profession do you ultimately want to accomplish, in what sort of facility do you want to work, and how do you want to spend your time each day? To get certified, you must pass an exam offered by the credentialing organization. Head to Chapter 9 for exam details and info on how to sign up for one. Going back to school Sharpen your pencils, acquire a gorgeous new backpack, and shine up an apple for the instructor because you’re going back to school. That’s right, school. It’s your first stop on the journey to Medical Billing and Coding Land. The good news is that medical coding is one of the few medical jobs with less schooling requirements. Translation: You won’t be spending decades preparing for your new career. Most billing and coding programs get you up and running in a pretty short amount of time, often less than two years. After you successfully finish a training program, you earn a certificate of completion. Note that this is different from gaining certification. To earn your certification, you still have to take certification exams offered by the credentialing agencies after graduation. Fortunately, a comprehensive medical coding and billing curriculum offers you the knowledge essential to ace the exams and achieve entry-level certification. Most programs give instruction in the following: ✓ Human anatomy and physiology ✓ Medical terminology ✓ Medical documentation ✓ Medical coding, including proper use of modifiers ✓Medical billing ✓ Claims filing ✓ Medical insurance, including commercial payers and government programs You can read all about your educational alternatives — from abbreviated study programs to more extensive prolonged programs — in Chapter 8, where I emphasize the advantages of some programs and the drawbacks of others. Planning for the Future As soon as you get your first billing and coding job — and probably even before that — you’ll start hearing about something called ICD-10, which is the 10th edition of the International Classification of Diseases (hence, the ICD), the common system of codes that classifies every disease or health problem you code. These diagnosis codes give a generic description of the condition or damage that was the spark for the patient/physician meeting. As a biller/coder, you use the ICD every day. ICD codes are also used to classify diseases and other health problems that are documented on various forms of health records, including death certificates, to help provide national mortality and morbidity rates. The ninth edition of the ICD classification (ICD-9) has been used in the United States since 1979. But ICD-10 is coming, ready or not, and it isn’t just an update to the previous version. ICD-10 is a fully new edition of dental billing company , with all codes rearranged and placed in separate categories. ICD-9 is the old-school coding categorization system, while ICD-10 is the new kid in town, and the distinctions between the two are pretty considerable. For starters, ICD-9 has just over 14,000 diagnosis codes and approximately 4,000 procedural codes. In contrast, ICD-10 has more than 68,000 diagnosis codes (clinical modification codes) and more than 72,000 procedure codes. Other distinctions involve how the codes are displayed (the number of characters, for example) and how you interpret them (deciphering the characters to know what particular groupings signify) (deciphering the characters to know what particular groupings mean). As of this writing, all healthcare practitioners are obligated to be ICD-10–ready by October 1, 2014. Because getting everyone around the globe over on the same page, so to speak, is such a huge effort, ICD-10 is being deployed in phases for just about everybody who has anything to do with utilizing it.
My interest in M4A started like a lot of people’s: In 2016 with the campaign of Bernie Sanders. As I slowly evolved beyond my progressive/neoliberal upbringing, I learned more about it and about the complete failure of the US Healthcare system.
As I learned more about the proposal, the more I liked it. But when pressed on specifics, I would hand-wave and away that Bernard had it covered in his bill. This book gets deep into the specifics, along with the 100+ year history of healthcare law reform in the US.
The overarching theme is clear: In this country, healthcare is a commodity in a market. M4A seeks to turn it into a public good. That is the only solution to eliminate the complexities, the bureaucratic muck, the highway robbery pricing, the insecurity the false choices. Every other effort is a half-measure that does not solve the underlying problem: Healthcare should be a public good, not a commodity, and not attached to your employment. It does not operate like a commodity, nor do the “consumers” operate as such. M4A would be cheaper and more efficient than the status quo, resulting in a healthier, more productive society.
Basically every single argument for and against M4A is discussed here with citations to studies that back up their claims. This will be my go-to book for all future discussions on the matter, and if you have any fleeting interest in the policy at all, you should read this book.
My only issue is that this book was published at the beginning of the year and didn’t include updated plague deaths or results of the presidential election (or even the Democratic Primary). It’s in need of an updated edition, though given how things are going with the plague, it’ll probably be quite out of date the instant it’s published.
Not much can be said negatively about this book by Drs. El-Sayed and Johnson. The concept of Medicare for all is explained succinctly, emphasizing the goals of providing universal and comprehensive coverage to combat current un/underinsured Americans by lowering out-of-pocket costs. Additionally, the goal is to be able to control pricing of care to combat the inflation of medical costs through private unregulated dealings between pharmaceutical companies and insurance companies. Through this control, progressive financing of care would be introduced to even out the cost disparities among the poor and the affluent. It also aims to combat large administrative overhead costs which account for a larger portion of healthcare spending. Ultimately, medical decisions would be back in the hands of physicians as M4A would encourage a breakup of hospital monopolies and a shift back to private practice, with less overhead and more focus on patient care rather than assembly line work.
I appreciated their comprehensive discussion of M4A, even emphasizing potential downfalls as well as addressing every counter point that the opposition has ever responded with, pointing out the emphasis on fear tactics to scare off wary Americans. They even examine several other variants of proposed changes to American healthcare, and compare and contrast to M4A. The fact that large corporations can lobby their enormous wealth and power through donations to campaigns and officials is preposterous, Citizens United must be overturned immediately. There will be difficulties in getting M4A passed through these barriers, but grassroots organization and overwhelming middle class support may give hope to the adoption of M4A. I’m excited to see how the public sentiment shifts and what happens to the policy in the next few decades.
The two authors (both doctors) set out to explain Medicare for All, How it would work, Why it is better, How to pay for it, and What trade offs would it entail.
They also show how our current system is so very broken, and how it got here. It shows that the current pandemic shows with terrifying clarity why the current system is so awful.
I think they do it perfectly. It goes into just enough detail on each point.
They also go into both what other plans would like like and their trade offs and what the politics would be to get something like this passed. Going over each shareholder and what their incentives are.
Only issue I would have liked to have further discussion on was pricing. The authors mention that many countries spend less and have less medical costs. They then go on to say that Medicare for All would give us much better health outcomes and switch a lot of the burden of payment to larger groups. But it confused me on why Medicare for All wouldn't bring the cost down as a whole.
This is nothing against the authors or the subjects but unfortunately I used to think that Medicare for All (or any single payer) was the number one issue facing the nation. I was wrong... It ties for number two with a number of issues but pales in comparison to the number one issue... voting rights. Without this we cannot have a chance at passing anything worth while... or having a democracy at all.
The reader was frustratingly slow, when sped up it made him seem electronic.
*Oxford Press sent this to me for free through a Goodreads promotion, but all thoughts are my own*
My initial thoughts: I hate America.
But also, this was a very concise break-down of the Medicare for All plan. I'm a 22-year-old American; I knew basically nothing about health insurance before I read this book. I was attracted to it for that reason. And because I have gone to the pharmacy and been told that I no longer have insurance with no warning, and also no inhaler which I need, for breathing purposes. Additionally, I have been on Medicaid my whole life and I never understood the dynamics at play due to that fact. Like the fact that doctors are far more likely to deny you service if you use Medicaid! That would have been good to know earlier.
So many people I know have stories like this, and far worse, and a laymen's guide such as this one could be a huge help in clearing up all the political confusion surrounding healthcare in the United States. I feel fully equipped with the knowledge to fully support Medicare for All after reading this book. And even if you are a strong opponent, it can never hurt to understand the arguments used by those who's views diametrically oppose your own.
AMAZING and concise explanation of the US healthcare crisis and suggested solutions. I liked that the book used the narrative of a patient and her family to tie it together. The only con was that I wanted the section explaining the benefits covered by M4A to be slightly more detailed — I felt like a lot of what was explained was, “it depends.” I guess that’s accurate, though! I also would’ve liked a bit more detailed on the opponents of M4A. Overall, though, amazing book! It’s hard to write a health policy book that’s not depressing or boring, but Drs. El Sayed and Johnson did an excellent job!
A great book to review if you are in the medical field or are interested in policy and workings of the current insurance and coverage. The cost of administration alone will shock you. I wish the book had a bit more holistic inclusion of political view points rather than presenting the reasons as to why M4A of either 1) lack of intelligence on the voters (by being influenced by marketing campaigns) or 2) not having 100% absolute control of congress that is dominated by progressive legislators (not just democratic party affiliation as the book outlines). I enjoyed the work of a research perspective into one of the most important challenges facing our society.
The authors of this book aptly state that "We wrote this book because much of the public conversation has been marked by a general lack of engagement with what [Medicare-for-All] really means, how it works, and what the challenges ahead actually are." This perfectly sums up the importance and value of this book. This is an excellent beginner's guide to what Medicare-for-All (M4A) actually is, how it could shift depending on different conceptions of the bill + funding, and the real challenges faced on a policy and politics level.
As a conservative who has worked in the healthcare industry, I was interested in reading more about Medicare for All. While I don't agree with some of the benefits and cost proposals put forth in the House and Senate bills, I agree that this program needs to happen. This was the 3rd book I've read on this topic and now I'm looking for books detailing the holes in the single payer system. Highly recommend this book for someone looking to understand not only the fundamentals about this program and some of the decisions that will have to be made by the legislature.
Reading this book both made me hopeful and filled me with rage. We have such a great blue print of how universal health care would work, we have research backing that it would help both financially and health wise…. Yet our political system isn’t actually designed to do what’s best for the people. Reading this as the new administration further fucks up our country was rough.
I do think the way this book spelled out what arguments and propaganda will be thrown at us against universal health care is so important!
I audio booked this one and I want to know everything about healthcare and I think everyone deserves to have healthcare but maybe I am too stupid to understand this complex system! Very informative! A lot to digest and comprehend, I think maybe I should have read this one so I can take it slow and highlight and bookmark and things like that so I think technically it’s 4-5 stars but I will give 3 because I was listening to it when I was doing frustrating analysis in the lab and it’s triggering to me now
Everyone should read this. It is not only extremely informative but it answers all the questions a person might have. Why should we pay so much more for health care and prescriptions than other developed countries? Why should the richest country have so many people uninsured? Why are some people so against it? If our health system is so great, why was it overwhelmed by Covid? Why should nurses have to go on strike for better wages? Why are some hospitals closing?
Drs. El-Sayed and Johnson do a great job of simultaneously unpacking and advocating for Medicare for All in its current legislative existence. This book first recounts America's fraught history with healthcare reform, before diving into the policy itself of providing healthcare as a right to all Americans. Informative, inspiring, and inviting.
I expected to read an outline for all the reasons *for* single payer. What I didn't expect was a thoughtful review of the history of medical insurance in the US as well as a relatively balanced description of the pros and *cons* surrounding single payer. They also cover the politics around passing Medicare For All.
A really comparative and digestible treaties on Medicare For All.
A rare well written and concise book on American policy, El-Sayed and Johnson do not leave anything uncovered. A relevant mix of facts and analysis help make their argument realistic and receptacle. It’s an extremely important topic that I believe more Americans should be educated on. I wish there were more books like this for other major policy initiatives.
Health care for all people is very near and dear to my heart, so I really appreciated this book. I'm not great at remembering details, so the numbers of projections and years in history probably won't stay with me, but I enjoyed getting to read any this issue's history and future in such depth.
Amazing guide to our healthcare system. The authors make an incredibly complicated topic digestible. Despite being quite liberal, I had my doubts about a single payer system, but this book convinced me otherwise! Highly recommend.
a concise, yet comprehensive outline of all things M4A that serves as a great foundation for diving deeper/understanding the current conversation & politics surrounding it. The authors perfectly accomplish the goals they set out for with this book.
The writing is a must read for all Americans. It will require more than one reading for me to understand all the points the authors explain. I cannot decide whether the reading helped or hindered the experience of the book.
This book was fascinating. It examined why US citizens pay more than any other country for medical care while getting worse health outcomes. It looks at multiple possible fixes and the benefits and drawbacks of each. It was so informative.
I feel like this was a non partisan explanation of the history of Medicare and the pros and cons for solutions to our current out of control healthcare costs. I'll read this again and have lent it to family
Fine! Breezy, packs a good number of stats into a tiny package. The more it was about the political organizing stuff the more I sorta glassed over, but still useful.