To many Americans the healthcare system is broken and in major need of overhaul. The good news is that the Affordable Healthcare Act of 2010 addresses many of America's healthcare problems. The bad news is that significant parts of the new healthcare law will phase in over the next three years rather than immediately, with all legislated changes scheduled to be implemented by 2014. Additional bad news is that significant problems with the American healthcare system are not covered in the Affordable Care Act of 2010.

In the year 1900 agriculture represented two thirds of the American economy. Today agriculture accounts for less than 3% of the U.S. economy. There have been huge advances based on research, technology, farm management and agricultural practices. Farms on average are much larger. In 1900 no one could have comprehended or predicted the changes that would happen in agriculture. The same level of change is needed in healthcare, but it needs to be accomplished in 10 years or less. President Kennedy challenged America to put a person on the moon within a decade and we did it. The same type of challenge and mobilization is needed in healthcare reform now.

Republicans fought passage of the law every step of the way and Democrats avoided many key provisions in the hope of getting a few Republicans in the Senate to support the bill in order to get it passed into law. The result is a less than perfect partial solution to a large-scale set of problems.

The Affordable Healthcare Act of 2010 is primarily health insurance reform legislation. The passage of this legislation was highly controversial. The new healthcare law addresses many issues that required attention for decades. There are parts of the law that can and should be improved on and there are many healthcare issues that still need to be addressed, especially dealing with the quality and cost of healthcare.

The Key Problems with the American Healthcare System

Following is a summary of many of the key problems facing the American healthcare system

1 – Healthcare costs represent over 17% of the American GNP and they are increasing significantly every year. On a per capita basis the U.S. pays significantly more for healthcare than any other country and it is hurting our economic competitiveness in world markets. Although America pays more for healthcare than other countries, our overall health and life expectancy is lower than many other countries. This alone is cause for concern and a wake-up call for action.

2 - Healthcare is too costly for businesses and consumers. For many employers and their employees, annual increases in health insurance costs have averaged 15% - 25% and more over the last few years due to actual increases in medical costs as well as insurance companies increasing premiums in anticipation of the healthcare legislation. The Affordable Healthcare Act partially addresses cost issues according to the non-partisan Congressional Budget office and most Congressional Democrats, yet Congressional Republicans say otherwise.

3 - Most people have an opinion about the new healthcare law and many strongly support or oppose it, yet few people know what the law includes and why they should support or oppose the law.

4 – While Republicans are trying to repeal the new healthcare law, there is no chance they will be successful. They cannot get 60 votes in the Senate to support repeal the healthcare law and if they could President Obama would certainly veto repeal.

5 - Hundreds of thousands of people work in insurance companies administering healthcare, however none of them actually provides healthcare services. This is a huge overhead cost to the healthcare system.

6 - Countless people work in doctors' offices and hospitals handling medical records, billing, patient scheduling, insurance forms and other paperwork using inefficient, error prone paper and partially automated processes.

7 – The U.S. has the best healthcare in the world for those that can afford it, yet millions of Americans get little or no healthcare.

8 - Americans spend billions of dollars every year on a myriad of diet plans, yet the average weight of Americans increases every year, resulting in epidemic levels of diabetes, coronary and other diseases and medical conditions. Millions more continue to smoke, use dangerous illegal drugs and follow unhealthy lifestyles. All of this is driving up healthcare costs.

9 - Medication developed and manufactured by American pharmaceutical companies is priced significantly lower in other countries than in the U.S.

10 – Healthcare quality is a very significant problem. Medical errors made by medical professionals including doctors, nurses and others are one of the leading causes of death and injury in the U.S. every year. In many cases, medical and cleanliness best practices are established but not followed.

11 – Medical malpractice insurance costs are too high due to medical errors, however if you or a family member is injured or dies due to medical errors, are you ready to have your right to legal recourse limited?

12 – With the exception of health insurance, Americans can buy almost anything across state lines. We travel extensively and often require healthcare away from our home state and we may need to travel out of state to get appropriate healthcare. Why not create competition by enabling health insurance companies to sell health insurance nationwide.

13 – There are too many health insurance options, making the selection of health insurance very costly. Why not simplify the policy choices and enable consumers to purchase health insurance online, significantly reducing health insurance sales costs?

14 -Millions of unmarried heterosexual couples in long-term relationships can't include their partner in their health insurance plan.

15 - Countless families have been wiped out financially due to serious illnesses either not covered or insufficiently covered by medical insurance, or because they could not get health insurance.

16 – Pharmaceutical advertising adds considerably to the cost of drugs. Advertising also significantly increases usage of pharmaceuticals as consumers learn about and push their doctors to prescribe medications that sometimes are not needed or appropriate.

17 – There have been wonderful improvements in medical diagnostic, operating room and other medical equipment in recent years, as well as important advances in pharmaceutical drugs. These advances are very costly and are at times being used beyond their appropriate need. Valid and unnecessary use of advanced medical tests and pharmaceutical products is helping to drive healthcare costs higher.

18 - In employee surveys (employee satisfaction surveys, employee opinion surveys and employee benefits surveys) employees are asked their opinions about and satisfaction with employee benefits they receive from their employer. Most employees across many industries are saying their health insurance costs are escalating much too quickly while their coverage is being cut back. Some employees are commenting in their survey responses that they are opting out of healthcare insurance because they can't afford it.

Concluding Thoughts

The Affordable Healthcare Act addresses some of the above and other problems, however there is much the new law does not address, or that is inadequately addressed.

Congress still has much to do regarding healthcare. Are they up to the challenge, or will Republicans continue to obstruct progress? Will Democrats support important issues that Republicans want to include in any new or revised healthcare legislation?

Today, as this article is being written, former Republican Senate Majority Leader Bill Frist came out openly supporting the Affordable Healthcare Act, openly challenging current Republican Congressional leaders and members. Bill Frist is a highly accomplished medical doctor. His strong preference is to keep the Affordable Healthcare Act and to enhance it to further address cost, quality, and other key issues. Hopefully Republicans in Congress will get Bill Frist's message.

Beyond the Affordable Healthcare Act of 2010, the American Recovery and Reinvestment Act of 2009 includes significant money in support of improving and streamlining the healthcare system including $25.8 billion for health information technology investments and incentive payments along with $10 billion for health research and construction of National Institutes of Health facilities.

As Americans are learning more about the actual provisions of the new healthcare law, the polls indicate they are becoming more supportive of it. Unfortunately millions of Americans were against the Affordable Healthcare Act due to misinformation and lies about the new law that was continuously spewed by Republican politicians and lobbyists.

The Challenge

• Are there new models of healthcare that will provide better healthcare at significantly lower cost?

• Should the Cleveland and Mayo Clinics serve as a model for providing healthcare excellence?

• Would a single payer approach to healthcare insurance bend the healthcare cost curve significantly downward?

• Should hospitals and doctors be paid at least partially based on keeping patients healthy rather than being paid only for treating medical problems?

• Should healthcare professionals practice more preventive medicine and less reactive medicine?

• Can Americans become more responsible for their own health, improving their diet, increasing exercise, losing weight, avoiding illegal drugs and excessive alcohol, and going to and listening to their doctor when they need to?

• Can doctors, nurses and other medical professionals learn and follow best practices in order to significantly lower medical errors?

• When will Americans be able to purchase health insurance across state lines?

• Will medical records be automated as called for in the Affordable Healthcare Act?

• Should pharmaceutical companies stop relying on Americans to subsidize costly development of new drugs by paying significantly higher prices for the same drugs sold in other countries at much lower prices?

• Should pharmaceutical companies stop advertising their drugs to the population overall, instead educating doctors about drugs and relying on doctors to prescribe appropriate medicines?

• Should there be a single carefully regulated and administered website that provides consumers with information about the performance of hospitals and doctors?

• When will unmarried heterosexual couples in long-term relationships be able to include their partner on their health insurance plan?

• Are too many costly diagnostic tests being performed and too many drugs being prescribed?

• On average, are doctors spending enough time with patients?

• When will American citizens have more influence with Congress than special interest groups and industry lobbyists?

• Will Congress finally do what needs to be done for the good of Americans rather than for their own partisan gain?