Is the US 'leading from behind' on health policy?

摘要

There is a common and perhaps understandable perception that the US is an international laggard when it comes to health policy. The US famously spends far more per capita than other countries, despite middling performance on key population health metrics. The country's political system and cultural traditions make it challenging at the national level to advance sweeping social policy of any kind, including health policy. The US was the last industrialized nation to enact a comprehensive health insurance plan for its citizens, for example, and implementation of that law, the 2010 Affordable Care Act (ACA), continues to be deeply controversial. The American health care system has historically been decentralized and fragmented and heavily influenced by interest groups.