Darcy Bryan, Jared Rhoads, and Robert Graboyes of the Mercatus Center at George Mason University explain a project that’s designed to improve American health care, not just scrap Obamacare.

Ranked No. 43, it looks as if North Carolina has some work to do.

The Healthcare Openness and Access Project (HOAP) is a collection of state-by-state comparative data on the flexibility and discretion US patients and providers have in managing health care. HOAP combines these data to produce 38 indicators of openness and accessibility. …

… There is broad agreement in the United States that it would be desirable to lower the cost and improve the quality of health care and broaden health insurance coverage. There is much disagreement about how this trio of goals is to be accomplished. The years-long political struggle over the Affordable Care Act (ACA, commonly known as Obamacare) is the most visible manifestation of this divergence of views. The ACA represents one approach to tackling the three goals. Many on the political Left argue for still-more-centralized public-sector control over health care and particularly for a federal single-payer insurance system. Policymakers and commentators on the Right have offered a variety of proposals that, generally speaking, would shift more power to private-sector entities and to states. All these proposals have one thing in common: they assume the key to lower costs and better care lies in reconfiguring the insurance system.

We believe the three goals of healthcare reform cannot be attained by fixating solely, or even primarily, on health insurance reform. States have (and should have) substantial control over the delivery of health care—and not solely or principally in the area of insurance reform. To make maximum use of state powers in improving care, it is vital to have a basis for comparison—to see what works in other states. The Healthcare Openness and Access Project (HOAP) is a set of tools providing state-by-state measures of the flexibility and discretion that patients and providers have in managing health and health care. In other words, how open are each state’s laws and regulations to institutional variation in the delivery of care, and how much access to varying modes of care does this confer on the state’s patients and providers?