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Meaningful healthcare reform requires understanding of our complex healthcare system. This book was written to help clarify the difficult and poorly understood issues and problems of American healthcare. Its purpose is to help us move forward on the many difficult decisions that should be made to improve our healthcare system. Our unique combination of public-private funding and free-market capitalism system has been a major source of medical care advancements over the last half-century. The entrepreneurial spirit of risk takers who have invested billions of dollars to push forward innovative ideas and products has been key to its success. We should not lose that driving force for medical advancements and our economy. Our American healthcare system needs reform. We should fix it rationally with a scalpel, not destroy it with a meat cleaver. To optimize and appropriately guide that reform, we should first understand and concentrate on the real problems. Primarily we should fix our healthcare system by decreasing its administrative complexity and inefficiencies. The Affordable Care Act should be modified significantly to make it more acceptable as part of our national effort for more meaningful reform. Rational solutions through political compromises are not easy to find in our highly polarized political environment. It will be a long uphill climb, but it is a challenge that we must meet for our uniquely American healthcare system to survive.