A message is seen on the computer indicating that there are too many visitors on the Affordable Care Act site to continue.
A message is seen on the computer indicating that there are too many visitors on the Affordable Care Act site to continue. - 
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One of President Barack Obama’s advisers on health care reform, Dr. Ezekiel Emanuel, acknowledges that many of the problems the Affordable Care Act faced during the first few months of its implementation were self-inflicted wounds.

"It’s a tremendous achievement, and I think unfortunately, the communication strategy wasn’t everything it should have been."

Emanuel chronicles the rollout and the history of health care reform in the United States in his new book, “Reinventing American Health Care.”

His enthusiasm for the overall changes to the health care industry is somewhat personal. He recalls his early days as a doctor, working with emphysema patients. Patients often returned to the hospital after failing to take their medication or to make improvements to their living arrangements. Emanuel attributes their lack of improvement to a lack of physician follow-up, something the Affordable Care Act incentivizes.

When it came to working with states in the roll-out, Emanuel says he did not anticipate the clash of ideologies that would ensue.

“We thought that for many states, they also recognized that it’s important to balance states budgets, that it’s important to give people health care because they become more productive, they stop worrying about that element and can focus on jobs, raising their family and other things.”

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Follow Kai Ryssdal at @kairyssdal