Gallup polls have been asking some big picture questions about the major dimensions of health system performance–quality, coverage, costs and access–for nearly two decades now. This allows me to show you a long time series of trends that leave little doubt that despite many lofty promises made for Obamacare (or the high hopes of its proponents), Obamacare essentially left American health the same or worse on quality, coverage, costs and access . I found literally no evidence in these data that it made things better.

The Democratic party is moving steadily toward a full embrace of Medicare for All as its official health-care policy. While the term is flexible enough to mean different things to different people, the overall direction is clear enough. The party is advocating for the enrollment — eventually — of all Americans in a government-run insurance plan of some sort.

Even here in the United States, government-run health care programs such as those of the Veterans Administration and the Indian Health Services have appalling records of patients dying while waiting for care.

For anxious mothers like me who don’t want to wait three days for results from a lab culture while my child suffers, government-run health care doesn’t promise speedy service.

Give Working Families A Break

The Trump administration is using its regulatory authority to provide Americans more flexibility and choices of affordable health coverage, but it should take additional steps to help working families struggling with the cost of health coverage.

The administration has proposed allowing employers to establish defined contribution arrangements that enable their employees to purchase health insurance plans available outside the workplace.

But an important new option would be for an employee to use an HRA contribution to buy into their spouse’s plan at work.

Last month, Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued a ruling declaring Obamacare unconstitutional. The case was brought by 20 Republican state attorneys general. Seventeen Democratic state attorneys general responded January 3 by appealing to the U.S. Court of Appeals for the 5th Circuit.

Judge O’Connor appears to be on a bit of an island — the conventional wisdom on both the right and left is that his decision will be overturned by a higher court.