Engel (Baruch College) provides a straightforward and accessible analysis of the health care industry and the forces that mold it in harmful ways. Engel's account considers the history of the industry, starting with the launching of Medicare and Medicaid and continuing through the current political and legal struggles over the Affordable Care Act. Factors such as employer-sponsored health insurance, profits, managed care, and reform attempts have made the US health care system profoundly dysfunctional compared with those of peer nations. Rising prices have forced insurance companies and employers to shift costs and risks to beneficiaries. And these issues will only intensify: the Congressional Budget Office predicts significant premium increases for those who have purchased plans through the state and federal exchanges. Taken together, these factors ultimately make comprehensive preventative and acute care "unaffordable" for average Americans. Yet many Americans remain resistant to further reform attempts. This text is geared toward readers who may lack expertise in the field but want to further explore key factors that drive the price of health care out of reach. Summing Up: Recommended. All readers. --Harry Holt, West Chester University