Health reformers have an established record of losing. Going into 2009, there were plenty of reasons to believe that they would fail again. A polarized political environment, soaring budget deficits, and myriad other obstacles stood in the way. Yet the Obama administration and congressional Democrats defied the odds. Democrats won the 2009-10 health reform battle by successfully applying lessons learned from past failures, including the importance of neutralizing interest-group opposition. The result is historic legislation that, given the constraints imposed by both the U.S. political and health systems, is probably as good as it gets.
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Jonathan Oberlander (2010) studied this question.
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