New Comic Book by MIT Economist Explains Health Reform Law

Health Care Reform Explained by Jonathan GruberMIT Economist Jonathan Gruber, who advised the Obama Administration on health care reform and was an architect of Governor Romney’s health care reform in Massachusetts, has written a new 152-page comic book that explains and combats some common misconceptions about the new federal health reform law, the Patient Protection & Affordable Care Act (“Affordable Care Act” or “ACA”), which some refer to as “Obamacare.”

The intent of the new book, Health Care Reform: What It Is, Why It’s Necessary, How It Works, is to explain in simple and clear language the complexities of the Affordable Care Act and what it means for the average person and business owner.

The arguments of critics are acknowledged in the book, and the author aims to present the facts in a clear and balanced way. Judging from glowing reviews by customers on, the book seems largely to have achieved its purpose.

In a description accompanying the book on Amazon, the publisher states:

“[F]rom the moment President Obama signed the [Affordable Care Act (ACA)] bill into law in 2010, a steady and mounting avalanche of misinformation about the ACA has left a growing majority of Americans confused about what it is, why it’s necessary, and how it works. If you’re one of them, buy this book. From how to tame the twin threats of rising costs and the increasing number of uninsured to why an insurance mandate is good for your health, Health Care Reform dispels false fears by arming you with facts.”

The New Book, by Jonathan Gruber with illustrations by Nathan Schreiber, is available for purchase in paperback from Health Care Reform: What It Is, Why It’s Necessary, How It Works

Some Facts About the Health Reform Law Explained

Among the questions about the Affordable Care Act which Professor Gruber answers and clarifies with a straight-forward presentation of the facts, are the following:

  • Why is health-care reform important? “We are facing a crisis in American health care right now. America’s health care system has become increasingly unfair, bloated, and out of control,” Professor Gruber states simply in an illustrated video accompanying the new book. “If nothing is done, within 70 years we will spend 40% of our national income on health care. At the same time, more and more Americans find themselves without access to protection against these rising costs,” the video explains. In a written interview, Mr. Gruber told Bloomberg’s Newsweek that health-care reform is important “because we have twin crises of a high and rising uninsurance rate and an unsustainable growth rate in health-care costs.” “The former has huge costs in terms of health and financial bankruptcy. The latter will eventually bankrupt our society.”
  • What is wrong with our current health care system without the Affordable Care Act? As summarized by a reader review of the book posted by Gaetan Lion on, “This short book makes you understand why the existing system is costly, unsustainable, broken, and dangerous. Every year the majority of individual bankruptcies are caused by medical related expenses (running probably at one million individual bankruptcies a year). And, over 20,000 die a year because of inadequate access to health care,” Mr. Lion states. “Defending the current system can only be explained as an act of ignorance. Similarly, screaming against the ACA as many have is also an act of ignorance,” opines reviewer Lion. “Gruber addresses all the screaming on either side of the aisle and simply states, Ok let’s cool down here is what ACA really is and is not.”
  • Why and how will the Affordable Care Act (ACA) help solve our health-care issues? “Because it fixes broken insurance markets to guarantee fairly priced coverage—leading to 32 million more insured Americans—and because it starts us down the path toward cost control through a number of innovative approaches,” Mr. Gruber summarized to Businessweek.

    In his illustrated video accompanying the new book, Mr. Gruber explains in simple language:

    “The ACA will address these problems in four steps:

    • First, it will make insurance affordable by providing public insurance and tax credits to offset insurance costs. An additional 32 million Americans will gain insurance coverage under the ACA.
    • Second, it will fix broken insurance markets so that insurers can no longer discriminate against the sick or deny you coverage because of a pre-existing condition.
    • Third, the ACA will begin the process of controlling health care costs, by setting up health insurance exchanges where insurers will have to compete for your business and moving towards a system of reimbursing doctors based on making you healthier, not how much care they deliver.
    • Fourth, the ACA will reduce the deficit – by more than $100 billion in the coming decade, through spending cuts and raising taxes on the highest income families.”

    “We know the ACA can succeed because it is based on a successful reform in Massachusetts. That reform reduced the number of uninsured by two-thirds and cut premiums in the individual insurance market by half – with strong public support.”

    “Health care is the largest and fastest growing sector of our economy, and remaking key elements of that system is challenging. But it’s worth it.”

    “At the end of the day, what everyone wants is to make sure we’re taken care of when we’re sick, and that it doesn’t ruin us financially to get that care.”

    “The ACA makes affordable health care a reality for all Americans,” the video concludes.

  • What are the most common misperceptions of the health reform law? The most common misperception of the law is “that it is ‘socialized medicine,’ Mr. Gruber told Businessweek. “In fact, this approach [the Affordable Care Act] builds on—and greatly expands—the private health insurance system,” he explained. In the video accompanying the book, Professor Gruber explains: “The ACA is NOT a government takeover of insurance – it represents an expansion of private insurance and will allow those who are happy with their insurance to keep their plans. The ACA does NOT impose death panels, and in fact helps seniors by filling in the “donut hole” in their prescription drug coverage.”
  • What is the individual insurance mandate, and will it require people to buy health insurance they cannot afford? Professor Gruber explains, “The ACA does NOT force Americans to buy insurance they can’t afford. A key element of the ACA is the individual mandate to purchase health insurance. Without the mandate, many healthy people will delay paying for health insurance until they are sick. When they stay out of the market, it drives up costs even more for all of us. The mandate is the spinach that we have to eat in order to get the dessert that is fairly priced insurance. But the ACA does not force people to buy insurance they can’t afford. In order to make the mandate fair there is an “affordability exemption” so that no one ever has to pay more than 8% of their income for insurance.”
  • Why is the individual mandate necessary? The book provides a surprisingly detailed explanation of the individual mandate, and why it is necessary. As summarized by Gaetan Lion, the reviewer quoted on, “If you want a system that attempts to cover all individuals and that is effective and reliable (no denial for preexisting condition, no annual and lifetime limits, no policy cancellation, no coverage denial) you need a mandate. It is simple: if the insurance industry can’t reduce their claim risk, they need to insure the whole population. With no mandate, the insurance industry would become insolvent due to the negative self-selected bias (only the sick and the old seek insurance). If people understood this straight forward concept, support for the ACA would not be an issue.”
  • What consequences would we face if the Affordable Care Act were to be repealed (or invalidated by the Supreme Court)? “Millions more uninsured Americans, a continued discriminatory insurance market, and no start on controlling health-care costs,” Mr. Gruber responded when Businessweek asked him this question.
  • Critics of the Affordable Care Act say it doesn’t address health-care costs. Is that perception correct? “It is important to recognize how hard this issue is—there is both enormous scientific uncertainty and a lack of political will to change. Given those constraints, the ACA goes as far as was possible at this time (and perhaps even farther),” Mr. Gruber told Businessweek.

These are just a few of the questions and issues about the health reform law explained by Professor Gruber in his new 152-page illustrated comic-style book.

Professor Gruber’s Illustrated Video Accompanying the New Book

In a video, illustrated with animated comic-style drawings like those in his book, author Jonathan Gruber provides a short summary of points made in his new book »

Commentary and Reactions to the Book and Illustrated Video

The Center for American Progress has featured the Jonathan Gruber illustrated video on its website, along with a presentation on The Affordable Care Act Is Already a Success; It’s Lowering Costs and Expanding Coverage for Millions.

The Center for American Progress also provides an Interactive Quiz on How Much Do You Know About Health Reform? Do “Death Panels” Really Exist?, where you can test your knowledge of the Affordable Care Act.

While most of the comments about the book posted by readers on are decidedly positive about the book and about the health reform law, at least one expresses an opposite view. “Gruber demagogues the most critical issues by recycling – without challenge – virtually every canard employed by advocates of so-called ‘progressive’ health care reform in the guise of fearsome monsters ultimately defeated by PPACA. In doing this Gruber reveals that, far from being the objective purveyor of fact, he is at best a cheerleader for the form of government-driven health care reform in which he has been an active participant,” writes one reader.

Such differences in opinion about the health care reform law characteristically seem driven by ideological differences about the proper role of government, without focusing on the facts of what is actually in the health care reform law.

In its review of the book, NPR refers to Professor Gruber as saying he was eager to write a book on the federal health reform law because he believes that those people who don’t like the concept of the law oppose it because they don’t understand what is in it. He points to a Kaiser Health Tracking poll taken in January, 2010, showing that when individual aspects of the law were explained, large majorities of those polled reported liking those aspects and liking the law more.

More Information

The New Book is available for purchase in paperback from Health Care Reform: What It Is, Why It’s Necessary, How It Works, by Jonathan Gruber

For more information on the Affordable Care Act and health care reform, see the HelpingYouCare™ resource pages on VoicesForCare™, including:


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