ABSTRACT
THE FOCUS OF THIS FIRST CHAPTER IS THE CURRENT SYSTEM of health care in the United States-where we are and how we got here. In 2010, after more than a year of contentious debate, Congress enacted the Obama administration’s Affordable Care Act (ACA). The ACA marked a significant step forward in a very long struggle to achieve national health insurance. It was not as ambitious as the Clinton administration’s Health Security Act of 1993, which failed to be enacted, but it positioned the United States to move toward universal health care and brought significant reforms in access, quality, and cost.
