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| Obamacare, much like Britain's NHS, will be a work in progress | Obamacare, much like Britain's NHS, will be a work in progress |
| (35 minutes later) | |
| President Obama clearly remains excited about the future impact of his signature healthcare reform package, the Affordable Care Act. Having succeeded where several of his predecessors in both parties had failed, Obama took to the podium Thursday to speak in support of what is commonly known as "Obamacare" (although apparently to refer to it as that is still felt in some quarters to be racist). | President Obama clearly remains excited about the future impact of his signature healthcare reform package, the Affordable Care Act. Having succeeded where several of his predecessors in both parties had failed, Obama took to the podium Thursday to speak in support of what is commonly known as "Obamacare" (although apparently to refer to it as that is still felt in some quarters to be racist). |
| Unfortunately, the fear that many individuals feel about the consequences when someone in their family is serious ill has so far been assuaged only at the expense at creating fear in business owners and senior managers about what the health reforms will actual costs them. | Unfortunately, the fear that many individuals feel about the consequences when someone in their family is serious ill has so far been assuaged only at the expense at creating fear in business owners and senior managers about what the health reforms will actual costs them. |
| Obama was clearly aware of that Thursday, with Republicans still getting mileage with their base from regularly voting to repeal Obamacare. The fundamental debate over the necessity of comprehensive reform is still open in the minds of many Americans. | Obama was clearly aware of that Thursday, with Republicans still getting mileage with their base from regularly voting to repeal Obamacare. The fundamental debate over the necessity of comprehensive reform is still open in the minds of many Americans. |
| The recent postponement of employer mandates from 2014 to 2015 unavoidably accentuated the fact that much is still in play. The full rollout of Obamacare, and its successful implementation, is not a foregone conclusion, especially as time frames extend past the next mid-term election. | The recent postponement of employer mandates from 2014 to 2015 unavoidably accentuated the fact that much is still in play. The full rollout of Obamacare, and its successful implementation, is not a foregone conclusion, especially as time frames extend past the next mid-term election. |
| The "old battles" that the president referred to in his speech may be in the past for him, but to many they are alive and well. Obama should not confuse wishful thinking with turning a blind eye to an important task that remains unfinished. In short, he needs to recognizes that he has not fully won the argument yet. More work must still be done. | The "old battles" that the president referred to in his speech may be in the past for him, but to many they are alive and well. Obama should not confuse wishful thinking with turning a blind eye to an important task that remains unfinished. In short, he needs to recognizes that he has not fully won the argument yet. More work must still be done. |
| Obama is right to stress that the size of the United States, with a population over 300 million, and the complexities of the current system, with many different providers and a private job-related insurance infrastructure that seems unable to keep up with advances in society, technology and longevity, makes the challenge of comprehensive reform gargantuan. | Obama is right to stress that the size of the United States, with a population over 300 million, and the complexities of the current system, with many different providers and a private job-related insurance infrastructure that seems unable to keep up with advances in society, technology and longevity, makes the challenge of comprehensive reform gargantuan. |
| As was remarked to me several times during my many years living in Britain, | As was remarked to me several times during my many years living in Britain, |
| The three largest economic organizations in the world are the People's Liberation Army, the Indian Railways and National Health." | The three largest economic organizations in the world are the People's Liberation Army, the Indian Railways and National Health." |
| Notably, when compared to the United States, Britain is a much smaller country (with a population of just over 60 million) that is significantly more homogeneous and concentrated. | Notably, when compared to the United States, Britain is a much smaller country (with a population of just over 60 million) that is significantly more homogeneous and concentrated. |
| Their single-payer system has become so entrenched in British life since it began in 1948 that Danny Boyle chose to feature it prominently in his opening ceremonies for the London Olympics last year. However, the NHS is still an work-in-progress that successive governments have had to wrestle with in order to ensure that it remains fit-for-purpose. | Their single-payer system has become so entrenched in British life since it began in 1948 that Danny Boyle chose to feature it prominently in his opening ceremonies for the London Olympics last year. However, the NHS is still an work-in-progress that successive governments have had to wrestle with in order to ensure that it remains fit-for-purpose. |
| As Obama attempted Thursday to reignite some enthusiasm around his reforms, a scandal concerning the quality of care for NHS patients is raging in Parliament, with Prime Minister David Cameron launching a scathing attack on the Labour Party for failing to address the entrenched mediocrity in the system during their previous 12 years in power. | As Obama attempted Thursday to reignite some enthusiasm around his reforms, a scandal concerning the quality of care for NHS patients is raging in Parliament, with Prime Minister David Cameron launching a scathing attack on the Labour Party for failing to address the entrenched mediocrity in the system during their previous 12 years in power. |
| Of course, Obamacare does not come close to being as comprehensive (and therefore as effective at capping costs) as the NHS, but it is still a massive undertaking that will take the country in a new direction. Obama made reference to there being "glitches" in the implementation of his reforms. Few Americans would have expected any government program, whether new or old, to be free of glitches. | Of course, Obamacare does not come close to being as comprehensive (and therefore as effective at capping costs) as the NHS, but it is still a massive undertaking that will take the country in a new direction. Obama made reference to there being "glitches" in the implementation of his reforms. Few Americans would have expected any government program, whether new or old, to be free of glitches. |
| This important issue at this time is not simply the arcane practicalities of this change or that change. The British experience demonstrates that, even though their approach has been so much more ambitious than what Obama ultimately settled for in 2010, there is never an end to the glitches. | This important issue at this time is not simply the arcane practicalities of this change or that change. The British experience demonstrates that, even though their approach has been so much more ambitious than what Obama ultimately settled for in 2010, there is never an end to the glitches. |
| Obamacare is not a single change that will be rolled out, celebrated and then forgotten. It is the first of an ongoing series of decisions, compromises and improvements that will likely be a feature of the domestic political landscape for decades to come. | Obamacare is not a single change that will be rolled out, celebrated and then forgotten. It is the first of an ongoing series of decisions, compromises and improvements that will likely be a feature of the domestic political landscape for decades to come. |
| This is precisely why it is so important for Obama to realize that, if he is serious about the success of what will almost certainly be his primary domestic policy achievement of his presidency, he must continue to make the fundamental case to Americans as to why his approach to reform is necessary. Showcasing this positive anecdote or getting wonky about policy details is not enough. | This is precisely why it is so important for Obama to realize that, if he is serious about the success of what will almost certainly be his primary domestic policy achievement of his presidency, he must continue to make the fundamental case to Americans as to why his approach to reform is necessary. Showcasing this positive anecdote or getting wonky about policy details is not enough. |
| He can't simply ignore the mounting concerns of small business owners and the lingering anxiety of individuals who are unable to grasp how the system will actually improve their daily lives. | He can't simply ignore the mounting concerns of small business owners and the lingering anxiety of individuals who are unable to grasp how the system will actually improve their daily lives. |
| Those glitches won't simply go away. | Those glitches won't simply go away. |
| Obama still has a case to make, both philosophically and morally, or else run the risk that his reforms may simply unravel in the face of Obamacare supporters struggling to follow the ground game of implementation and Obamacare opponents who are being drip fed a steady flow of unflattering and contradictory status reports. | Obama still has a case to make, both philosophically and morally, or else run the risk that his reforms may simply unravel in the face of Obamacare supporters struggling to follow the ground game of implementation and Obamacare opponents who are being drip fed a steady flow of unflattering and contradictory status reports. |