The future of Obamacare

The United States, among democracies, was late in establishing universal health care for the same reason that the health care it has established, the Affordable Care Act (aka Obamacare or ACA) is wildly complex by the standards of most health systems. The basic problem is that the United States has a deliberately fragmented and fragmenting political system, rife with “veto players” who can change or frustrate legislation. It is far easier to block legislation in the United States than in other rich democracies. As a result health legislation in the United States is rarer, far more complex and full of the compromises needed to get anything passed.