The U.S. health care delivery system ranks low on safety, efficiency and equity. The 2008 America's Health Rankings revealed that "the health of Americans has failed to improve for the fourth consecutive year. Key factors contributing to these results included unprecedented levels of obesity, an increasing number of uninsured people, and the persistence of risky health behavior, particularly tobacco use."
Recent studies indicate that the current economic crisis and the health care crisis are closely linked; middle class incomes have stagnated over the past eight years, resulting in what Jacob Hacker of Yale University calls the "great risk shift". According to Dr. Hacker, there has been a thirty year erosion of social insurance and safety net programs, including pensions, unemployment and disability insurance, and private health insurance. Medical debt is one of the leading causes of bankruptcy and home foreclosure in the U.S. National spending for health care has nearly doubled in the past ten years, and it's expected to double again in the next decade, without any corresponding increase in health quality or outcomes.