Health Care Reform:

U.S. Health System Gets Dismal Score

Appetite for Reform?

The commission urged U.S. policy makers to take broad steps to guarantee universal access to health insurance.

But that goal has proven politically hazardous, most recently in 1994, when the White House tried and failed to execute broad health insurance reforms, led by Sen. Hillary Rodham Clinton (D-N.Y.), then the first lady.

Ever since, lawmakers have shied away from comprehensive reforms in favor of smaller, incremental steps.

Medicare is beginning to use financial incentives to convince hospitals, nursing homes, and others to report quality information to the public.

And the government is slowly shepherding the development of electronic medical records like those already widely used in many European countries -- another of the commission's recommendations.

But experts warned that, overall, reforms are moving too slowly to keep up with a rapidly aging U.S. population.

"The security of a healthy nation is at stake. Actions are urgently needed," says Cathy Schoen, the commission's research director.