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Book Review: How Obamacare Is Unsustainable
May 15, 2015

If you haven’t read local resident and physician Dr. John Geyman’s book, HOW OBAMACARE IS UNSUSTAINABLE, Why We Need a Single-Payer Solution for All Americans, you should. While you may not agree with every assertion Dr. Geyman makes in the book, you probably agree that (1) our healthcare system is broken, (2) the politicians are unlikely to agree on a good solution to it, and therefore (3) the only way it will change is if we all get educated about it. And if you are like me, our healthcare system is relatively opaque to you. Dr. Geyman gives a compelling explanation of what is wrong with the system and why.

As the book title foretells, Dr. Geyman makes two broad assertions in this book: that the Affordable Care Act (ACA, otherwise known as “Obamacare”) is not a sustainable solution, and that the proper solution is for the government to pay for all healthcare utilizing non-profit healthcare providers (the so-called “single payer” system).

In the first part of book’s two parts, Dr. Geyman identifies many problems with our current healthcare system, which of course includes the ACA. However, it is not clear from the book whether the ACA has caused these problems or simply failed to fix preexisting problems. Dr. Geyman identifies some ways in which the ACA has helped, e.g. additional enrollment of the uninsured, and some ways in which the ACA has hurt, e.g. made things more complicated. But the book gives the impression that the main problems with our healthcare system predate the ACA and that the ACA has failed to fix them.

The second part of the book argues that the only possible solution to the problem is a “single payer” system. In a single payer system, the government sets the standards of care, e.g. what tests should be run in any given situation, sets the prices for that care, and then pays for it. All consumers get the same benefits. Healthcare providers then compete for the consumer’s business. However, they are paid only for the care that the government decides is necessary and only the prices that the government sets. Medicare has similar features today.

Dr. Geyman also advocates for a return to the non-profit healthcare provider model. According to Dr. Geyman, when he began practicing decades ago, doctors and hospitals cared more about patient service than profit. Over time, healthcare has become a business. Dr. Geyman believes that the profit motive is destroying healthcare in this country.

I believe our healthcare system is the most pressing problem in this country and is getting worse. The first half of Dr. Geyman’s book is very helpful in understanding why our system is failing. Dr. Geyman’s opinion on the appropriate cure, which involves removing healthcare from our market-based economy, is debatable. I, for one, am skeptical that a single-payer system is the only possible solution. But even if you are a staunch capitalist, it is worth reading this book to understand the problem. Dr. Geyman’s arguments are hard to ignore.


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