“America’s health-care system was badly in need of reform when President Obama took office. But instead of improving America’s health-care system, the president and his allies have made matters worse. The core problem in American health care is that there is not a functional marketplace in health insurance or health services to discipline costs and promote quality and value for consumers. Rather than empower consumers or encourage the kind of innovation that could make high-quality care cheaper and more accessible, Obamacare has shifted decision-making authority from states, employers, insurers, and consumers to the federal government. This centralization of power in the federal government has already crippled the private initiative that is so essential to delivering improvements in the quality of care for patients. Obamacare’s defenders will insist that for all its flaws, it will nevertheless expand coverage. Yet even after a ten-year gross expenditure of $2 trillion, Obamacare will leave 31 million Americans uninsured in 2021 and beyond.”