There is no doubt that the American health care system has a history of being in disarray. Despite the introduction of the managed care, which was intended to help bring costs down, the cost of health care continues to rise. In addition to the spiraling costs of the health care system, millions of Americans still could not afford any form of health care insurance. The question is what can be done about it? The answer is neither easy nor clear cut. In 2010, the Patient Protection and Affordable Care Act (PPACA) of 2010—commonly called the Affordable Care Act (ACA) or Obamacare, after its major backer, US president Barack Obama—sought to reform a number of aspects of the US health insurance industry, as well as improve the access to and quality of health care services.

Keywords Americans with Disabilities Act; Best Practice Protocols; Fee for Service System; Grassroots Activism; Gross Domestic Product; Industrial Democracy; Managed Care; Medicaid; Medicare; Single-payer System; The Pepper Commission; The Rehabilitation Act - Bill 504

Health Care Reform in the U.S.
Overview
Health care is very much on the minds of Americans. Former presidential candidate Hillary Rodham Clinton made health care her platform and insisted that universal health care is achievable. Although affordable health care for everyone sounds like a positive step forward, the American public was not sure enough of that statement to support her election as president. The American health care system is bound to the insurance industry and has always been a fee for service system. To add to the dilemma, universal health care does not have universal support of the American people or the medical profession.

Further Insights
Managed Care
Managed care was an initiative in the private sector to address the spiraling costs of medical care, created to "manage health care costs." Managed care has