ST. LOUIS When federal lawmakers agreed in 2010 to pass the Affordable Care Act, they recognized that the U.S. health care system was in desperate straits.

Not only was the cost of health care significantly higher than in other industrialized nations, but Americans were among the unhealthiest populations in the Western world.

Nearly four years later, the system remains in crisis. While the growth of health care spending has slowed, it is still climbing. And despite higher costs, Americans health outcomes have not significantly improved.

Other wealthy nations achieve longer lives, lower infant mortality, better access to care, and higher care quality while spending far less, states a January 2013 report by the nonpartisan Commonwealth Fund.

The Affordable Care Act was never intended to immediately halt these basic trends; improving health outcomes and quality of life while cutting costs is a tall order. But the nations volatile, partisan debate over what is popularly known as Obamacare seems to have missed that point.

The tech-savvy Obama administration was expected to deliver a user-friendly website that would increase Americans access to health care by subsidizing insurance coverage. But HealthCare.gov was a bug-ridden disaster. And many consumers have voiced sticker shock over the higher monthly premiums and higher deductibles of insurance plans for 2014 both on and off the online marketplaces, also known as health exchanges.

The stalled rollout has bolstered the new laws opponents, including Sen. Ted Cruz, R-Texas, whose quasi-filibuster helped trigger a federal government shutdown last fall. Cruz has blasted the federal mandates on health insurance policies and vowed to repeal every syllable of every word of Obamacare.

The most simple rule of economics is there aint no such thing as a free lunch, Cruz told the Texas Tribune in 2012 when he was running for Senate. Everything you mandate that an insurance policy cover drives up cost, which means there are more and more people that cant afford to get insurance.

But where does that leave us? Regardless of how you view the overall merits, regulatory strictures, or societal costs of Obamacare, consider these facts:

In the United States, health care spending eats up nearly 18 percent of the gross domestic product, which is the sum of all goods and services produced in the country. This figure could reach 21 percent by 2023.

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Four years after passage of Obamacare, health care system remains in crisis