Barack Obama will have to manage expectations.

Barack Obama is an amazing speaker and his message of "change" has struck a chord both in the United States and elsewhere. The senator will now have to manage expectations because the challenges are pretty tough. For instance, the extension of health insurance to all Americans defeated the Clinton administration. The imposition of an NHS style solution would be defeated by the size of the U.S population. Health schemes throughout the world are coming under pressure of increased costs and longevity whatever their funding model.
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The president-elect of the United States will benefit from Democrat majorities in the Sentate and in the House of Representatives. If he brings the same competence to bear as he did for the election campaign, which raised a record amount of money, then Obama could be well-placed to reach his goals. He can make quite a few changes to Bush policies by executive order.