[...]There's a parallel in how we should think about constructing a health system in America – or replacing one. Former President Obama's impulse to conduct an intensive intervention to major fix parts of the U.S. health system was understandable, but unwise. Seeking to replace the Affordable Care Act (ACA) with another intensive intervention would also be very unwise.
To appreciate why, consider the scale of such undertakings. In 2015, total U.S. health spending reached $3.2 trillion. That is larger than the economy of Britain or France. Indeed, if the U.S. health system were a separate country, according to World Bank data it would be the fifth largest economy in the world. So the ACA attempted to re-engineer the equivalent of the economy of France in one bill, produced by the American legislative sausage-making machine. Hey, what could possibly go wrong?!?
