As a result, health outcomes remain inferior to those of the OECD and inequalities are significant. By and large, the reforms have been going in the right direction. The reasons for the limited progress thus run deep and are difficult to capture, especially in an environment where information systems are not geared toward that objective. In part, slow progress may be attributable to the magnitude of the task at hand. In fact, insufficient attention is being paid to measuring actual progress towards effective implementation.