¶ … health care in the United States has been the source of heated debate for a number of years. Although the publicity surrounding the issue has been considerable and made to look like it is a recent problem facing the nation, the problem, in reality, has been on the horizon for nearly a century. During President Woodrow Wilson's administration, efforts were unsuccessfully made to pass national legislation regarding the delivery of health care in the United States and the issue has appeared periodically on the national agenda ever since (Lepore, 2009). Finally, on March 23, 2010, among massive controversy, the Affordable Care Act, through the massive efforts of the Obama administration, became law. Despite the passing of the Affordable Care Act, health care in the United States remains dismal for a large percentage of American citizens. Although there were a number of significant provisions in the Act that took effect nearly immediately such as extending the coverage of coverage for adult children on their parents' policy until age 26 and the extension of coverage for children in general, most of the bill has little or no effect on most uninsured until calendar year 2013. The fact is, that despite the fanfare and debate, the Act still leaves over 17 million Americans uninsured.

The Affordable Care Act is a step forward in the delivery of health care in America. Even the most ardent supporters of the Act would argue that it is not a panacea for what ails American health care but, assuming it withstands court challenges presently pending in the U.S. Supreme Court, it does soothe some of the problems but others remain.

The Affordable Care Act plugs some of the more obvious problems but there remain considerable other ones that need addressing. There is no shortage of available approaches to the delivery of health care in the western world and the American system has appropriately borrowed some of these ideas in formulating its own but, presently, what are the restrictions on health care that are most problematic (Shi, 2003)?

Americans spend nearly $7,000 a year per capita. Canada, which trails the United States in per capita expenditure, spends only $3,326. Proponents of the American system argue that the costs of health care may be high but that the system provides the best available care in the world. Opponents argue otherwise. The United States has one of the highest infant mortality rates and is not among the leaders in life expectancy. Critics of the American health care system indicate that both statistics belie its overall quality.
One of the other arguments offered in support of the American health care system is that the system works far more efficiently than systems such as Canada or Great Britain where long individual waits for medical service are reported or where waits for specialized services are measured in months instead of weeks like in the United States. The short wait times in the United States can be misleading. First, it must be remembered that he wait times in the United States are being compared with countries that nearly all have universal health coverage. In the United States one quarter of the population lacks health insurance coverage and, therefore, are much less likely to seek health care. Additionally, even those who are insured in the United States tend to avoid medical treatment because of the out-of-pocket costs involved. In countries where universal health care is available, individuals are seeking treatments that are completely left out of the American system.

Health care in the United States is also restricted by the fact that the available pool of physicians are not getting the job done. First, there are far too few primary care physicians available to make the system work effectively. The reasons for this are numerous but the primary reasons are the relative low pay and prestige afforded such physicians. As a rule, medical students have historically been drawn to higher paying specialties such as orthopedics or surgery…