The leader of a great democracy wants to make his mark by reforming health care. He fears that if left untouched, the system could become so expensive that it will bankrupt the country. Others before him have tried for comprehensive reform but failed.
Political resistance to his plan is fierce. He must proceed with extreme caution. Above all, he must promise voters that the reformed system will look nothing like its dreaded counterpart across the Atlantic Ocean.
The leader in this case is British Prime Minister David Cameron. He wants to reform the National Health Service, the government-run system that covers all citizens. Among his ideas is to promote greater competition among providers, both public and private.
The outcry in response has been furious. Opponents have accused him of trying to make the one change that few in England can abide - creating "American-style" health care.
Most people in England like their system just the way it is. A recent poll found that 59% believe it is the envy of the world. An overwhelming majority, 69%, sees the system as a crucial element of British society and want everything possible done to maintain it. Only 15% would like the system to be completely rebuilt - less than half the percentage who feel this way in the United States.
The British don't think their system is perfect. But nothing seems to scare them more than the thought that it could become like America's. Many find it unbelievable that, at least until Obamacare kicks in, millions of people in the United States who lack insurance can't get needed care.
In response to the backlash, Prime Minister Cameron has scaled back his reform plan substantially. His retreat is seen by some as a defeat, and it may come with a political price.
We can take two lessons from this experience. First, the deeply emotional and divisive health care debates we have had in the U.S. are not unique. It is a highly sensitive subject in many countries.
Second, and perhaps more importantly, critics of foreign systems should be careful of what they condemn. Opponents of Obamacare have stoked fears that it will create British-style health care. They may be throwing stones from a glass house.
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