A guarantee of health coverage to all Americans has on and off been at the forefront of American politics since Franklin Roosevelt's New Deal.
President Johnson, a legislative maestro, hammered through Medicare and Medicaid, and if not for the Vietnam War might have been able to go the whole way and insure everybody, not just the elderly and the poor.
President Nixon came close and had he not been forced out of office might have pulled off his National Health Insurance bill.
At his state of the union address, President Clinton waved a wallet-sized card that would, he said, take care of all our health-care needs. Unfortunately, he turned the job of securing passage to his wife, who had no official standing and no power base in Congress and the program failed before even getting a vote.
It seemed as if President Obama would succeed where the others failed. The Affordable Care Act, his top legislative priority, passed in March 2010, with no support from sullen Republicans, even though the bill incorporated many of their ideas and was based on two GOP prototypes, a white paper by the conservative Heritage Foundation and a health plan in Massachusetts engineered by Mitt Romney.
During the presidential campaign, Romney seemed to run away from his own program although it was generally considered a success. The GOP came up with the slogan, "Repeal and Replace," and voted 42 times to repeal "Obamacare." Their one try at proposing a replacement, a system of vouchers, proved politically unpopular, so the Republicans have settled on simply trying to repeal the law in hopes that something better will turn up later.
The Obama administration has had three years to prepare for the introduction of the Affordable Care Act and has so far botched it, badly but maybe not irreparably. As of Thursday, only 27,794 people had selected a plan through the federal exchange and 79,391 though the state exchanges, out of a universe of 48 million Americans without health insurance.
In the meantime, millions of consumers had their private plans cancelled or were warned that they faced cancellation because the plans did not meet the standards of the Affordable Care Act.
Taking much longer than he should have, Obama relented and agreed to allow the insurance companies to continue selling the policies the administration deemed inadequate for another year. However, this grudgingly granted extension doesn't solve the problem, only buys time for the administration to fix the law.
If we are to have a health-care system comparable to other wealthy, developed countries -- and we're running behind the curve -- Obama has to get this right.
It's not as if there is something better in waiting; there is nothing in waiting if this law doesn't succeed.
Dale McFeatters is a nationally syndicated columnist.