Written for nonexperts, this is a brisk, engaging history of American healthcare from the advent of Medicare and Medicaid in the 1960s to the impact of the Affordable Care Act in the 2010s. Step by step, Jonathan Engel shows how we arrived at our present convoluted situation, where generic drug prices can jump 1,000 percent in a day and primary care physicians can lose a fifth of their income at the stroke of a Congressional pen. Unaffordable covers topics ranging from health insurance, pharmaceutical pricing, and physician training to health maintenance organizations and hospital networks. Engel offers comparisons with other nations and provides insights on ethical quandaries around end-of-life decisions, neonatal care, life-sustaining treatments, and the limits of our ability to define death. While describing the political origins of many of the federal and state laws that govern our healthcare system today, he never loses sight of the impact that healthcare delivery has on our wallets and on the balance sheets of hospitals, doctors' offices, government agencies, and private companies.