He knows Americans aren’t interested in hearing about “vision” at the moment. The bottom line is that people have to be able to pay for the cure their doctor has prescribed for them.
If we were not speaking about the president of a country that has just sent 30,000 more soldiers to Afghanistan and has Haiti kidnapped with a passive invasion of more than 10,000 Marines, I would say that Obama is putting himself in the list of revolutionary leaders of the continent.