Health care reform in the United States

The debate over health care reform in the United States centers on questions about

• whether there is a fundamental right to health care,
• who should have access to health care and under what circumstances,
• who should be required to contribute toward the costs of providing health care in a society,^[1][2]
• whether the government should support health care commerce by forcing citizens to buy insurance or pay a tax,^[1][2][3]
• the quality achieved for the sums spent,
• the sustainability of expenditures that have been rising faster than the level of general inflation and the growth in the economy,
• the role of the federal government in bringing about such change
• concerns over unfunded liabilities.

62% of all personal bankruptcies in the United States were medical.^[4] Medical impoverishment is almost unheard of in wealthy countries other than the US^[5]. The United States spends a greater portion of total yearly income in the nation on health care than any United Nations member state except for East Timor (Timor-Leste),^[6] although the actual use of health care services in the U.S., by most measures of health services use, is below the median among the world's developed countries.^[7]
According to the Institute of Medicine of the United States National Academies, the United States is the "only wealthy, industrialized nation that does not ensure that all citizens have coverage".^[8] Americans are divided along party lines in their views regarding the role of government in the health economy and especially whether a new public health plan should be created and administered by the federal government.^[9] Those in favor of universal health care argue that the large number of uninsured Americans creates direct and hidden costs shared by all, and that extending coverage to all would lower costs and improve quality.^[10] Opponents of laws requiring people to have health insurance argue that they would impinge on personal freedom^[11] and would not contain health care costs.^[12] Both sides of the political spectrum have also looked to more philosophical arguments, debating whether people have a fundamental right to have health care which needs to be protected by their government.^[13][14]
Recent reform efforts under the Democratic-controlled 111th Congress and President Barack Obama have focused on two bills: the Patient Protection and Affordable Care Act (known as the "Senate bill"), which became law on March 23, 2010^[15][16] and was shortly thereafter amended by the Health Care and Education Reconciliation Act of 2010 (H.R. 4872) (which became law on March 30). No Republicans supported either bill.^[17]
Reuters and CNN summarized the March 2010 reforms and the year in which they take effect.^[18][19]