The State of the Union Address: What the President Got Right on Healthcare


January 30, 2014

In This Article

Grading US Healthcare

In 1994, when the Clinton plan was being considered, the US score was 55. Had the Clinton plan been adopted and fully implemented, the score would have been 70. Of course, that plan went nowhere.

In 2005, I graded the US healthcare system at 52. By 2009, the total score had decreased to 42, key losses being in access, cost, and quality.

Obamacare was enacted in 2010. Rollout of features was gradual, with the full law implementation only now in 2014.

As with any start-up, problems have been many. For a law that affects nearly one fifth of a gigantic economy, enormous inertia and robust resistance are to be expected.

Using a football analogy, it is early in the first quarter. The kickoff was fumbled, passes intercepted, numerous penalties incurred. It was a very public mess. President Obama gets it. Many of the process issues have been fixed. The future will assess the value of the substance.

Assuming full implementation of the ACA as enacted with few changes, I project a US healthcare system score of 64, with the main gains coming in access, quality, cost control, and prevention of disease.


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