Health-Care Reform Could Be Obama's Toughest Challenge

"I think the American people are in a very different place than they were in the early 1990s when Hillary Clinton had her health plan. Americans now know firsthand that managed care often doesn't deliver what it promises, that people are paying more out-of-pocket so even the middle class is feeling that the current situation cannot continue," Fentiman said.

"To some degree, it's the American way. This is the third or fourth time in my 30-year career we've talked about this, but, until the pain becomes great enough, we tend not to want to make change," said Dr. Nancy W. Dickey, president of the Texas A&M Health Science Center and vice chancellor for Health Affairs in the Texas A&M System.

"Change is frightening. Perhaps we're at a point where the pain is great enough and the leader articulate enough that we may be able to do it this time," she said.

But change won't happen overnight.

"It'll probably transform over the course of a decade or two," Cutler said. "The hope is that within 10 to 15 years, we will have health care that's cheaper and higher quality."

More information

For more on health-care reform, read this HealthDay story, and this fact sheet from the Office of Management and Budget.