Kindle eBook
Unnecessary Deaths
How the Trump Administration Undercut(s) Global and US Health Care and Medical Science
About the book →Coleman Publishing · 2026
Hostile Takeover
How Wall Street and Congress Hijacked American Healthcare and How We Can Take It Back
In May 2025, a diagnostic test at a cancer care center came back with a bill for $31,272.25. After a five-month "review," the insurer paid $0.00.
This book begins with a shocking premise: the American healthcare system is not broken. It is working exactly as designed.
The EOB is the product
If you have American health insurance, you've seen the words on an Explanation of Benefits: "This is not a bill." It's a document that often precedes financial ruin anyway.
The soaring costs, the denied claims, the paperwork, the medical bankruptcies — this book argues they aren't the result of incompetence. They're features of a system engineered for one purpose: generating returns for shareholders by limiting how much care patients actually receive. The EOB is the mechanism that transfers risk from corporations to families.
Hostile Takeover traces that machinery from the individual denial, to the human cost it produces, to the political protection racket that keeps it profitable — and then spends its final chapters on the counter-offensive: a federal blueprint built on the VA, and a state-level blueprint already drafted in Washington state.
“The American healthcare system is not broken. It is working exactly as designed.”— Introduction
What kind of book this is
It moves from diagnosis to prescription.
The first seven chapters expose the mechanics of the takeover — the denial machine, the human damage, the fraud, the political machinery protecting it. The final three lay out a citizen's blueprint for reclaiming the system, built on institutions that already work.
The cure is not theoretical.
The federal blueprint leverages the VA and Medicare, systems already operating at scale. The state blueprint points to a specific, drafted bill — Washington state's Washington Health Trust — as a working Phase One prototype.
It follows Unnecessary Deaths.
Robert Coleman's prior book asked why people were getting hurt, sick, or dying when solutions existed. Hostile Takeover picks up where that left off, asking who and how — who is behind the failures, and how the system was deliberately reshaped to prioritize profit over stability.
The Evidence
A system built to deny, and rarely challenged
11.81%Initial claim denial rate in 2024, up 16% since 2018.
<1%Of denied claims are ever appealed.
82%Of appealed Medicare Advantage prior-authorization denials are fully or partially overturned.
Nearly 50 million Medicare Advantage prior-authorization determinations were issued in 2023 alone. When patients or providers actually push back, the reversal rate suggests most of those initial denials should never have happened — a system that profits from exhaustion, not error.
The human and financial cost
| Documented impact | Figure |
|---|---|
| Patients who report a measurable health decline during a claim-denial waiting period | 60% |
| Patients denied care who never receive the treatment at all | ~1 in 4 |
| Higher preventive-care denial rate for Asian, Hispanic, and Black patients vs. white patients | nearly double |
| Physician time spent weekly on insurer administration rather than patients | ~20 hours |
| U.S. physician burnout rate vs. the general workforce | 82% higher |
| 2025 DOJ healthcare fraud takedown — the largest in U.S. history, 324 defendants charged | $14.6B |
The single-payer case
31%Of U.S. national health expenditures go to administration — far above single-payer systems like Canada's.
17.7%Of GDP spent on U.S. healthcare, more than any OECD peer, for worse outcomes.
The book's central counter-example is the VA — the country's own largest single-payer-style system. Veterans treated at VA hospitals show a 4.5 percentage point higher 28-day survival rate than those treated at private facilities, while costing 21% less per episode of care, even as the VA faces proposed staffing cuts of over 17% of its workforce.
“The VA proves that when you remove the profit motive, you can provide better care for less money.”— Chapter 7
Figures above are drawn directly from the book's sourced chapters and its 2025 DOJ, HHS, CDC, and peer-reviewed citations. The book's own annotated bibliography documents each source.
Contents
What the book examines
Part One — The Diagnosis
- The Denial Machine. How claim denials became a central profit mechanism, and why the appeal system exposes it.
- The Human Damage. Patients driven into debt, physicians pushed into moral injury and burnout.
- The Corruption Tax. Inside the 2025 record-breaking DOJ fraud takedown, and the Minnesota case that showed fraud as the system's predictable output, not its exception.
- The "Sick Care" Business. How the profit model is structurally aligned against prevention.
- The Protection Racket. The political machinery — lobbying and financing — that keeps the system in place.
- How the U.S. Compares to Other Countries. Spending and outcomes benchmarked against OECD peers.
Part Two — The Prescription
- The Single-Payer Solution. The economic and health case, using the VA as America's own working proof of concept.
- A Federal Counter-Offensive Blueprint. A three-phase, six-year plan built on expanding the VA and Medicare.
- A State's Counter-Offensive Blueprint. How Washington state's drafted Washington Health Trust bill serves as a working Phase One prototype.
- Two Philosophies, Two Futures. The choice between the current trajectory and the reclaimed alternative.
Conclusion — Logical, Moral and Economical Endgame. Plus two appendices: a look at the 2026 healthcare coverage crisis as enhanced ACA subsidies lapse, and a full annotated bibliography.
The blueprint already has a bill
Chapter 9's state-level counter-offensive isn't hypothetical. It points directly to the Washington Health Trust — the same drafted legislation covered in depth in One Card, One Cure and the case for single-payer healthcare elsewhere on this site.
Not the same book as Behind the System
This standalone book is a separate, independent publication from Behind the System, Book Two of The American Healthcare Investigation trilogy — which was originally drafted under the working title "Hostile Takeover" before being renamed. The two share only that drafting history, not content or series membership. How the two relate.
A $31,272.25 bill. An insurer that paid $0.00.
The system isn't broken. It's working exactly as designed.
Every figure on this page is documented and sourced in the book's own annotated bibliography.