Compared to what? Compared to virtually every other developed country in the world. There are numerous studies done each year by international, non-partisan, unimpeachable sources.

Inefficient? Now understand that I'm talking about our entire healthcare system, not just Medicare/Medicaid. U.S. healthcare cost are now about 17% of GDP and growing both consistently and dramatically. Some estimate that our healthcare costs will consume 25% of GDP by 2050. Healthcare costs are rising far faster than the incomes of U.S. citizens. That's the very definition of inefficiency.

Ineffective? There are certain things that U.S. healthcare does very well. We are at the cutting edge of cancer treatment and certain specialized surgeries. But the overall health of Americans lags that of many developed countries. We are more obese. Our life expectancy is among the worst of the developed countries. U.S. infant mortality rates are also in the lower third of developed countries. Much of those results may be due to the fact that around 30% of our population has no healthcare insurance. We are the only developed country that does not have healthcare insurance programs covering all of their citizens. ObamaCare did mandate coverage for the vast majority of Americans, but as you know that may be reversed as the result of either legal decision or political action.

Unaffordable? We spend more than double on healthcare than the next most expensive developed country, almost $7,600 per year for every single American. And I noted above, we don 't get results that are as good. Healthcare costs have been rising at about 10% a year in recent years, while personal incomes have been flat to down. Again, if that continues, it's the definition of unaffordable.

As further background, I'd recommend reading the following paper authored by two very knowledgeable and non-partisan researchers under the sponsorship of The Urban Institute.

http://www.urban.org/uploadedpdf/411...re_quality.pdf