Having made an ambitious campaign pledge and staked his domestic credibility on the promise to radically reform and restructure the health insurance industry, Barack Obama has been forced to endure a sticky summer of sliding poll ratings and sustained Republican attacks. One gets the impression that even die-hard Democrats are slightly ‘over’ their initial enthusiasm for an overhaul, and it’s starting to look as though it may take a lot more than a spoonful of sugar to help this particular medicine go down.

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