The premise of the novel is based on a real document written in 2002, copyrighted in 2003 by the author. This document is titled Medicare for Americans. From the scathingly cynical pejorative derogatory of the prologue, which sets up the struggles of the main character to implement his vision for healthcare in America in a corrupt society and political system. It follows an orderly timeline for selection of allies to help him implement his strategy to reform healthcare. Their characters are embellished as they fight government actors, assassination, and politicians and their appointees. The systematic logical implementation accruing populist support, financial support, and ultimate success are augmented with rich development of the characters and their relationships. The book culminates in the uplifting success of the premise, and a hopeful vision for America.