Barack Obama has become the first sitting US president to publish an academic paper, focussing on his flagship policy – Obamacare.
In the article, Mr Obama discusses the advances made by the Affordable Care Act (ACA) and outlines a blueprint for future improvements to the health care system in the US.
“I decided to prioritise comprehensive health reform not only because of the gravity of these challenges but also because of the possibility for progress,” he wrote.
The paper – called United States Health Care Reform: Progress to Date and Next Steps – was published by the prestigious Journal of the American Medical Association (JAMA), and has been viewed more than 500,000 times.
Although the article – published as a ‘special communication’ - was not formally peer-reviewed, the journal’s editor-in-chief Howard Bauchner told Bloomberg it had been revised and edited.
“While we of course recognised the author is the president of the United States, JAMA has enormously high standards and we certainly expected the president to meet those standards,” he said.
Mr Obama, occasionally derided as 'Professor Obama' by right-wing populist critics who claim he is too intellectual, admitted in the paper that he had not solved all the problems with the American healthcare system.
"Too many Americans still strain to pay for their physician visits and prescriptions, cover their deductibles, or pay their monthly insurance bills; struggle to navigate a complex, sometimes bewildering system; and remain uninsured," he said.
However, he added: “The ACA experience… makes me optimistic about this country’s capacity to make meaningful progress on even the biggest public policy challenges.
"Many moments serve as reminders that a broken status quo is not the nation’s destiny.”
According to the paper, around 20 million Americans have gained insurance coverage since the launch of the policy, with the number of uninsured people falling to historic lows.
The sharp decline in readmission rates also suggests the policy has improved the quality of care, Mr Obama said.
While Democratic presidential candidate Hillary Clinton has said she will continue to work on the ACA, the Republicans' Donald Trump has said he will scrap the policy and replace it with something better, although he has given details of his scheme.