Why Health Care Reform's Success Is Really A Popularity Contest In a debate hosted by Intelligence Squared on Jan. 15, competitors argued on both sides of whether the Affordable Care Act, or "Obamacare," is so irreparably damaged that its successful implementation is beyond rescue. After the debate, aside from the sketchy numbers released by the Dept. of Health and Human Services (HHS) this week, one question still lingered: does Obamacare have to be "popular" in order for it to survive, or can it evolve over time? In short, the answer to the first half of that question is "yes." If no one signs up for Obamacare, it will be kind of impossible to deem the law a success. But maybe Obamacare's initial popularity isn't the correct barometer to measure its success. As panelist Jonathan Chait pointed out, many of the reforms that we readily accept today were met with fierce opposition upon first introduction. Child labor laws, Medicare, and Social Security were all brushed off as "socialist," not unlike the Obama administration's health care reforms now. "It's ideologically understandable that they would oppose these laws," said Chait, "but they translate this ideological terror into a series of verifiable predictions about what will happen if these laws come into effect. And one day we're going to look back at the kinds of predictions they've been making about Obamacare, and those will go in the time capsule. But what if Obamacare doesn't evolve the way child labor and social security did? We all know that some of the law's key provisions, especially the widely advertised website, got off to a tremendously rocky start. The panelists in favor of the motion, who believe that Obamacare is already beyond repair, argued that the concept of insuring people who really need it is great, but the execution is just not going to work - not now, not ever. Obamacare was a response to a flawed healthcare system. There's no question about that. But it makes things worse. It reduces choice and competition in health plans," said Dr. Scott Gottlieb, in support of the idea that Obamacare is beyond rescue. It increases costs by reducing the productivity of the practice of medicine [...] Obamacare works against its own laudable intentions. There are far better ways to address issues of the uninsured in this country and far better ways to address the issues of those who are priced out of the insurance market. It will be interesting to see how things pan out with the law. Over two million people signed up for plans between Oct.1 and Dec. 28, 2013, which could mean registration in the insurance marketplaces is finally picking up steam. In the meantime, the Obama administration is trudging right along, touting the Affordable Care Act's benefits, and lending a deaf ear to its critics.