The florid title with its cornucopia of adverbs and adjectives suggests that this book is a guide to profound changes in the US health care system that will be produced by the Patient Protection and Affordable Care Act of 2010 (ACA). The prospect of a bold, systematic effort to look beyond the politics of enacting the ACA, the vicissitudes of implementation, and the fragmented projections of specific, already visible developments seemingly generated by the ACA (e.g., greatly increased merger and acquisition activity) to discern the overall shape of the organization, delivery, and financing of health care in the post-ACA era is exciting. But this book by one of the thought leaders in American health care and academic medicine—and an architect of the ACA—attempts to accomplish two other tasks on the way to that desideratum and, therefore, fails to provide the systematic exposition...

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