One of the outstanding features of the American health system is the high cost of medical care compared to other OECD countries. One explanation for this costintensive medical practice is a constant quest for excellence in the field. Besides this cultural specificity, economic regulatory policy leaves little leeway for negotiating prices. Competition between insurance companies is mostly based on the quality of healthcare and not on the price. This means that access to health care goes to the highest bidder. In addition, the setting up of healthcare networks have, over time, encouraged healthcare providers to consolidate and group their activity into lobbies, making it difficult to regulate prices. All this has led to significant discrimination in terms of access to health care as well as huge deficits for public schemes. In this difficult context, further aggravated by the economic crisis, the expected outcomes of the health reform are all the more urgent. However it is unlikely that this reform with its two-fold objective of extending health care coverage to a wider population while at the same time maintaining current regulation mechanisms, will succeed in limiting inflation of healthcare costs.