A new study in the New England Journal of Medicine found that, contrary to conventional wisdom, every American — regardless of gender or ethnicity — gets roughly equal routine medical care.

Other studies have shown evidence of racial disparities in treatment, and this study doesn't totally refute those. There are still disparities in access to some kinds of specialized care, and the methodology doesn't really address barriers to seeking care in the first place. But once people sought care, they were treated generally the same.

The real kicker, though, is that that the care was rather uniformly mediocre.

The study ... found that though there are some disparities, the world's most affluent health system fails to provide all patients with optimal care at least 40 percent of the time.

"Differences exist, but they pale in comparison to the chasm between where we are today and where we should be," said chief author Dr. Steven Asch of Rand Health and the Veterans Affairs Health Care System in Los Angeles. "No matter who you are, it's almost a flip of the coin as to whether you get the care that experts want for you."

We spend more money per capita on health care than any other nation on earth. And what do we get? Mediocrity.

There are many things wrong with our healthcare system beyond the skyrocketing costs. Most reimbursement systems end up giving bizarre incentives to healthcare providers, driving up overall costs. And it simply makes no sense that the cost and quality of health insurance coverage depends on one's employment status. Not only is that bad policy from a public health perspective, but increasingly it is a competitive disadvantage to American businesses and a barrier to hiring, constricting employment and economic growth.

It is time we seriously considered alternatives.

People talk about healthcare rationing, but the alternative to rationing is exploding costs — which eventually leads to rationing by ability to pay. Perhaps exploding costs would be acceptable if we were getting top-of-the-line care for all that money, but we're not.

Should nationalized health care be on the table? Sure. I don't think it's the best alternative, but it's arguably better than the system we have now.

Worried about a huge new bureaucracy? Right now, we're subject to a private medical bureaucracy instead of a government one.

National healthcare limits choice and results in long waiting lists for non-emergency procedures? Well, all systems have their problems. I just don't see the logic in trying to boast about our system and bash every flavor of national healthcare out there. None of the systems are perfect; they all represent different attempts to address the cost/benefit ratio.