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Turning a cruise ship around in a narrow channel is child’s play compared to what’s involved in changing a national healthcare system. Forget that millions of lives are involved in profound organizational change as compared to the matter of a few thousand paltry souls on a pleasure ship. In a systemic turnaround of an entire sector of the economy, the considerations that must be taken into account are infinitely more complex as well as more important. In addition, there’s the politics: the fact that the captain, the crew, the passengers and the owners all seem determined to steer this particular vessel in different directions probably doesn’t help.

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