In this chapter, the most important reasons for introducing ObamaCare will be analysed. Their more detailed examination will, to some extent, answer the question: Were the new regulations in American health care needed at all? The size of health care spending as a share of GDP in the USA is reasonably higher than in other countries and in 2013 (a year before ObamaCare) it amounted to 16.4%. For comparison, next in order, the Netherlands and Switzerland show 11.1% share in GDP, and the average for OECD countries is 8.9% of GDP. However, the problems associated with the ever-increasing costs are not a new phenomenon in the US health care system. An important issue will be distinguishing between costs and expenses, as (despite some similarities) the terms are not synonymous and yet are often used interchangeably. The discussion leading up to the introduction of ObamaCare also led to some confusion in this regard. Another and very frequent reason for introducing ObamaCare was a significant number of Americans without health insurance (the uninsured). The problem of many uninsured Americans is one of the key threads in political and expert debates about changes in US health care. It was no different during the presidential campaign of Senator Obama who often emphasized the importance and the need to solve this problem. The World Health Organization study, which assessed health systems in 191 countries based on several criteria, also had some influence on the proposed changes. In the WHO report ‘The World Health Report 2000: Health Systems: Improving Performance’, the USA took only the 37th position. Such a distant position among other developed countries meant that in the USA there were more voices calling for further interventions and changes.