Book excerpt: Burdened with perennially rising costs and responsible for providing health insurance to more than one sixth of all Americans, Medicare in its original form is fiscally and demographically unsustainable. In light of dramatic reforms under the Affordable Care Act (ACA), this book provides a comprehensive overview of the current state of Medicare. Eleanor D. Kinney explains how the ACA addresses systemic problems of cost and volume inflation, quality assurance, and fraud. Recognizing the potential for more radical change in the future, Kinney also explores the potential of Medicare to become a single-payer system. Comparisons are made with national health systems in Canada and the United Kingdom, from which the United States can draw valuable lessons. An approachable yet comprehensive account of Medicare and the ACA, this book will be invaluable for health care professionals and informed citizens.