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Well, every politician for the past 100 years has known that health care reform is the “third rail” of politics. And, if they didn’t know before Massachusetts, they know it now. So, why did health reform fail this time? Is it for the same reasons it has in the past or is there something unique about this moment or this president’s strategy for health reform that seemed to get so off track? While the history of health care is fascinating and the commonality of failure can make it seem that there is a hex over health reform that has infected everyone who tries, each failure of the major efforts at reform actually has its own unique set of causes. What is common about all of them is that the public cares a lot about health care — it is truly a personal issue. What is also common is that the public generally is more comfortable with systems that are known — even if largely disliked – than with approaches that are unknown or unclear. That is, the public generally has a fear of change. Opponents have always had an easier time engendering fear among Americans about what is proposed than proponents have had in helping people see the advantages of proposed changes.