If you're going to create a mammoth-sized government bureaucracy, make sure you have enough support in place to implement it fully on DAY ONE.
Obamacare, if it cannot be implemented fully in a more timely manner, and works at 95+% reliability, it could very well signal the BEGINNING of the end of the modern welfare state, and it will further create a greater chasm to form between Americans dependent on government services, and the wealthiest and most powerful Americans.
Too much power concentrated into the hands of the HHS Secretary has led to the current insurance debacle. It is too much to ask of the Secretary to implement Obamacare by herself. Also, the contractors and current bureaucracy charged with rolling out the law are clearly incompetent, as well as trying to accomplish too much, too fast.
The lack of so-called "bi-partisianship" has brought the government operations to the current atmosphere in Washington, and until there can be further cooperation between the two parties, there can be no confidence with the government and enacting laws designed to broaden the welfare state.
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