Obama's health-care promise that people can keep their insurance comes back to haunt The damage comes not just from the fact that it does not happen to be true, which hundreds of thousands who had bought coverage on the individual market are learning as they receive notices of cancellation from their insurers. The deeper problem with that promise is that it attempted to gloss over the fact that choices and trade-offs were part of the effort to reform the nation's sprawling, troubled health-care system. Many of those decisions go to philosophical and ideological questions that divide how Democrats and Republicans, liberals and conservatives, look at the world. Should people continue to have the choice to buy insurance that, for many, will turn out to be inadequate? Or should they be forced to purchase only what the government deems satisfactory? The Affordable Care Act settles those questions on the side of government having more say about what options Americans will have when they buy insurance. But instead of making the case for that change - and what it would cost - Obama insisted that people who are satisfied with what they have would see no difference. Health care is not the only area in which the Obama administration has clung to a we-can-have-it-all message. It also, for instance, has played down the impact of curbs on carbon dioxide and other air pollutants from coal-fired power plants. Rather than straightforwardly acknowledging that the regulations will help drive coal plants out of business - and arguing that the damage to the industry will be outweighed by environmental and public health benefits - administration officials have insisted that these are achievable standards that will maintain the nation's diverse energy mix. Obama's reassuring sales pitch on health care represented an effort to avoid the political pitfalls that others encountered when trying to overhaul the system in the past. In 1994, for instance, the Clinton administration's effort to insure the 15 percent of the population lacking coverage foundered because of the fear that the proposal generated in the 85 percent who had insurance. Obama "was sort of overlearning the lessons of Hillary Clinton's time on health care. What destroyed Hillary Clinton's plan was that people became convinced they were going to lose their health care," said Elaine Kamarck, who was a White House aide at the time and now heads the Brookings Institution's Center for Effective Public Management. "The one lesson that was learned about messaging was that you had to guarantee people that nothing will change," she said. In fact, the individual market - where about 15 million people who do not get coverage from their employers currently buy it - was overdue for change. It has long been notorious for selling skimpy policies that do not come through when consumers need them most.