Abstract

The passage of U.S. President Obama’s healthcare reform plan and positive response after that from the general public indicates that the issue of affordable access is more than a number of needy souls not being able to get care. It is arguably a competitive issue, much as it is a social policy challenge to a country reeling in a scrambled multi-polar world that is effectively mediated by strong productivity growth in Asia, Latin America, and with international capital flows. All of these observations point to a structural reality that the U.S. needs to address, including a good health care infrastructure under a comprehensive supply- as well as demand-side innovations. So after this letter of intent (reform proposal’s passage), to be Canadian, a Brit, or a Swiss, it will be argued here that history will be playing up against pragmatism in the crafting of desirable direction of reform, making the challenge for Obama all too real.