With the United States Supreme Court set to begin considering the Affordable Care Act (the historic healthcare reform derided by opponents as "Obamacare"), it is worth noting that the number of people in the US without health insurance reached an all-time high in 2010, the year the law was enacted. Roughly 50 million US residents (one in six) pay out-of-pocket for medical expenses.

Most rich countries choose to finance their healthcare publicly for several reasons. First, free-market healthcare is usually inequitable and inefficient. Individual needs vary significantly and private companies are often unwilling to insure the very people who need the most care (such as those who are already ill, or who have conditions such as diabetes, which predispose them to other health problems). Moreover, those who buy care - insurers and patients - are unlikely to have the information necessary to choose the safest and most effective treatments.