In a constitutional republic like the US, it’s simply too risky to execute major improvements in a big bang fashion. It’s not that different from engaging in a multi-decade software migration project. Sometimes, small changes is really the only path forward.
Part of the reason why Obama, initially a unifying force, eventually became known as a Divider In Chief (in addition to some racial commentary around police work) was that the bold changes of Obamacare left too many victims behind who ended up worse off.
You have to start with the principles of the country and work with them in mind, if you expect to be successful. You also have to assume future change will be dependent on the political winds of the future.
There is likely a lesson somewhere here about introducing “lean healthcare” style of changes instead of “big bang,” but I haven’t taken the time to articulate them.
Maybe starting with principles and making yearly changes that can easily be undone or redone by future administrations is the only path forward.
Part of the reason why Obama, initially a unifying force, eventually became known as a Divider In Chief (in addition to some racial commentary around police work) was that the bold changes of Obamacare left too many victims behind who ended up worse off.
You have to start with the principles of the country and work with them in mind, if you expect to be successful. You also have to assume future change will be dependent on the political winds of the future.
There is likely a lesson somewhere here about introducing “lean healthcare” style of changes instead of “big bang,” but I haven’t taken the time to articulate them.
Maybe starting with principles and making yearly changes that can easily be undone or redone by future administrations is the only path forward.