One of the biggest stakes in this past election was whether or not the ACA ("Obamacare") would survive. According to the law, most of it wouldn't be implemented until 2014. So if Romney and the Republicans won, he would most likely not implement it or implement it poorly even if Congress somehow failed to repeal it. But now that Obama has won, he's free to implement the law without further input from Congress (which is good because we're going to be seeing nothing but gridlock from Congress until at least 2014).

Because the law was designed to appeal to moderate Republicans (even though none actually voted for it) and appease insurance companies, it's not a simple single-payer system but instead a complex system of exchanges.

Sarah Kliff at Ezra Klein's blog has this Rube-Goldberg diagram that represents the exchange system.

She also describes how the ACA allows states to come up with their own scheme (so there would be fifty variations of the above chart) or let the Federal government do it. And it's turning out that the Federal government will be doing it for a lot of states. That's good because the more consistent this process can be the more sense it will make and the more effective it will be. But it means a lot of work for the Obama administration; almost more than they will be able to handle, according to Kliff.

Now, the worry on the right is that these exchanges, if set up by the Federal government, will be a back door to single-payer (i could link to Free Republic or World Net Daily, but would you want me to?). And i'm hoping that for once their conspiracy theories turn out correct. Because setting up access to a centralized system that is already proven to be effective would be a much better use of time than setting up that mess above.