I received the newest addition to the CTHPP Book Club — Reinventing American Health Care: How the Affordable Care Act Will Improve our Terribly Complex, Blatantly Unjust, Outrageously Expensive, Grossly Inefficient, Error Prone System — when the author, Ezekiel Emanuel, came to an ICER boarddinner in Boston this spring. He spent the evening talking and strategizing with a small group of prominent health care stakeholders and leaders who all care deeply about comparative effectiveness research and other ways to build a smarter health care system. Reading the book felt as if he was bringing the country into that fascinating conversation. As one of the primary architects of the ACA, he is naturally a big believer in the potential of the law to transform our broken health care system. But he is not blind to the challenges and problems – both in the law and in implementation. The book is an accessible overview, explaining both the bill and the problems in the US health system within the context of history and current politics. But he goes further than other ACA authors in candidly describing the problems of implementation, internal and external, future challenges, health care megatrends, and very specific predictions about the future of health care in America.