James Arthur knows where the US medical system is - half- again as expensive per head as anybody else's, no more effective for the fully insured than anybody else's, and the worst for the population as a whole of any advanced industrial country.
What's actually necessary to make it work better is to make it a properly universal system, like the medical care systems in every other advanced industrial country.
Obamacare is step in that direction. It's dropped the percentarge of medically uninsured Americans from 18% to 11.9%, so there's a way to go yet.
Rational observers don't seem to think that it's making medical care more expensive. Spending on medical care seems to be rising everywhere, as people live longer and treatments for more conditions become available (and worth buying).
The US does suffer from a remarkably expensive health care. Canadian observers have put a lot of the blame on an over-administered system, which has a higher proportion administrators to health carers than systems in other countries.
Malpractice insurance in the US is remarkably expensive, and ambulance-chasing lawyers are presumably counted as administrators rather than carers.
It's not - in fact - clear that it does cost more. The system has changed, which always means that some people are going to end up paying more, and complain about it, while others are going to pay less, and will be less likely to make a fuss about it.
The phrase "affordable" meant that it was intended to allow some people who couldn't previously afford health health insurance to take it on. A 6% rise in the proportion of the population insured suggests that it succeeded.
However "odd" the mechanism may be, it does what it was intended to do, though perhaps not as much of it as it should.