US Health Reform Bill passed

I was pleased to see the news just now that the Obama Government's Health Reforms have finally (after much public debate) been passed.    It's great that Obama has been able to make such a significant change happen, after a relatively short time in office (though admittedly it hasn't happened yet - there are a few more possible hurdles).  But  I wonder how he managed that, when Kevin Rudd, who by all accounts works himself, his staff, and his government ridiculously hard, hasn't actually achieved much in the way of significant reform (and not just symbolism)?

My theory is that pushing people to deliver at the rate that Rudd has been doing, is counter-productive.  It isn't a sustainable way to work, as evidenced by high staff turnover, loss of corporate knowledge, low morale, many sections of the commonwealth public service under incredible stress.  No wonder, working at a mad pace, without a clear purpose and without achieving results is incredibly stressful and demoralising.   When you work at that pace you forget why you're working, and become incapable of seeing the big picture - all you focus on is what you have to achieve, right then, right there.    People need time to collect their thoughts, come up with the ideas, make things work.    That's how you get results.  You treat people like people, not machines.  Working under pressure like that is only effective when it's in the short term.  Then, you can focus on an achievable, known goal.

Back to the US, though:  the system is not the same as the Australian system, keeping a high level of responsibility on employers to provide health insurance for employees.
"Republicans said the plan would saddle the nation with unaffordable levels of debt, leave states with expensive new obligations, weaken Medicare and give the government a huge new role in the health care system".  


I'm not really sure how the latter two problems are problems, and how the first one is true.  At the moment the US spends a record amount on health care, with extremely poor results - highest (and rising) infant mortality rate in the developed world, etc.  Surely even a conservative would see that reform is needed if you get such poor outcomes for such a big outlay?