Since taking office president Obama has swiftly implemented a plethora of initiatives which can be characterized as featuring profound differences in direction, policy and processes. Differences not just from the previous administration, but different from anything undertaken in the United States ever before. Different not just to shake things up, but different to set things off. New directions to address new concerns. And much of it designed so that the debates and subsequent responses will require in-depth review of many assumptions and beliefs that underlie much of our present political policies.

The entire portfolio of initiatives being addressed has been expertly positioned and focused under three top level issues - The Economy, health care, and Education. This is marketing mastery, as it sets forth a platform for communicating news, issues, and accomplishments in easy to comprehend sound bites that feature unprecedented clarity and relevance to elites, everyday Americans, and the world.

With a backdrop of record unemployment, declining retail and housing sales, and global economic upheaval the Obama administration has attacked status quo thinking and policy across a broad array of policy areas. At least that's how it looks. While there is evidence of change in economic policy, foreign policy and approaches to health care - there is more evidence of compromise that waters down the change that is needed.

In health care, instead of insisting on government funded coverage for all - which has been derided as "socialism" by some - the administration has moved to a proposition that seeks to lower costs. As if in the toughest economic crises in history with millions of people out of work for the foreseeable future, these people and the multitudes of working poor will be able to have health care if the cost is simply lower.

And where in any of the current health care proposals or public discourse are the changes that address the root issue of disparities in the distribution of health care? Research shows that the United States is a great place to be sick if you're rich and among the world's worst if you're poor. This condition is easily transferred to other areas of American life and alludes to a systemic practice of American systems consistently favoring elite interests - but that's another conversation. Between 1996 and 2005, premiums for households that received health insurance through work coverage rose from 7 percent of their total income on average to 10 percent. But the disparities are highlighted by the fact that for households earning more than $130,000, the increase was from 2.6 percent of total income to 3.3 percent. While households earning below $27,300, already paying an incredible 14 percent of total income for health coverage, saw their costs rise to 20 percent.

In many cases the cost of health care for poor and middle-class families rivals the cost of their homes or primary residences. Simply put there has been no highly visible and substantive conversation on 1) Why the rich - who can afford to pay more - pay so much less; and 2) Is American taxpayers deciding to make health care a priority expenditure of their tax dollars not an effective and desirable act because some want to label it "socialist". Arthur C. Brooks, president of the American Enterprise Institute, the conservative research organization, said referring to the administration, “They want much more of a European-style social democracy in which people are far less exposed to the vicissitudes of a market economy, and they want to have much easier access to manipulating the private-market economy.” So, after all that we've seen related to inadequate government regulation and the impact of private sector depressions on the lives of working citizens - are these not preferable outcomes?

The fact is that in America even good-health has become a privilege only afforded by the rich. And to put the global picture in perspective, in Canada and France, for example, health care accounts for 10 percent of all spending, as compared to the United States' 16 percent. Yet life expectancy is lower, and infant mortality is higher in the United States. And contrary to the purported superiority of our healthcare system, the United States ranks 50th in life expectancy among the nations of the world, well behind not only Canada and France (which rank 8th and 9th) but also Israel (13th), Jordan (38th), and Bosnia and Herzegovina (43rd). So we might ask if we have vastly superior health care technology and capability, yet people live longer in 50 other places in the world, perhaps we need to redefine the success criteria of our health care systems to include ensuring access for all and leading the world in these vital statistics.

In my blog 'Insane' I spoke to my concerns about achieving change without changing the people responsible for driving it. There are signs that this is a valid concern, especially around important issues like Network Neutrality which determines the freedom of Internet use and ultimately the future of free speech and opportunity for individuals and start-ups to freely publish. As I write media and network giants are buying influence and the positions of once pro neutral elected officials are changing in concert with the influx of contributions. This is but one area where change is not happening.

To his credit - and there is much credit due - president Obama has told us that he alone cannot achieve the change we seek. We must be vigilant and keep our voices strong. And while I feel there is much to be done in making the case for the administrations calls for citizen support, the fact is that we have a president who is not only making the request, but has setup the mechanisms for citizen input. It is a simple equation really. You want to control your country then take control. If the game is money, then put your money in and assert your positions. For the next four years at least the American people will have the ability to contribute and pool their money against the private interests, and an administration that is listening.

So speak-up!