Four years after Obamacare became law, the U.S. still took last place in an annual survey of health care systems in industrialized nations. The Commonwealth Fund, a health care think tank, found that the U.S. is overpaying for poor quality, as WaPo reports:
Not only did the U.S. fail to move up between 2004 and 2014 — as other nations did with concerted effort and significant reforms — it also has maintained this dubious distinction while spending far more per capita ($8,508) on health care than Norway ($5,669), which has the second most expensive system. […]The data for the 2014 report was collected before the Affordable Care Act (aka Obamacare) went into full effect, so that reform may eventually boost the U.S. out of last place by providing health insurance to some of the 50 million people who lacked it. But, according to the study, the problems of our health-care system remain so pervasive that it will take more than better access and equity to resolve them.
This cannot be repeated often enough: Even if you think Obamacare is both a good law and a successful one (an uncertain claim on its own), the truth is that it leaves intact almost of all the major structural problems that make our health care expensive and subpar. The debate over the biggest health care law in recent history has therefore been almost entirely irrelevant to the problems actually plaguing our system.We have a few quibbles with the Commonwealth report, however. For example, healthcare is more expensive in the U.S. than in other countries in part because we invent a lot of new drugs and equipment that benefit the rest of the world while sparing it the costs of research and development. But even with all necessary qualifications, Commonwealth is right to draw attention to the persistent structural problems we face. It’s time for reform, and here’s what we should do first: Lower costs by expanding the number of care providers while working toward re-inventing the delivery of care.