Yeah, for instance the biggest overhaul of the healthcare system (Obamacare) happened without really trying. Imagine what he would have done if he was in office not playing golf. Also, looks like you are a time traveller from October 2012. So a flashback for you

http://whatthefuckhasobamadonesofar.com/

> Yeah, for instance the biggest overhaul of the healthcare system (Obamacare) happened without really trying.

I was watching during the selling before the voting for Obamacare, and I concluded that Obama did next to nothing.

What did happen? The Dems had both houses of Congress. Senator Kennedy had long had a team working on healthcare overhaul and had a plan on the shelf. That plan got pulled off the shelf, modified, and then rammed through, e.g., by Pelosi, Reid, and Emanuel.

For Obama, when he went to a town hall to support the bill, he made some remarks about the costs of an amputation, got his facts badly wrong, got slapped down by the American College of Surgeons for saying things that were "uninformed, misinformed, just plain wrong, dangerous"

  http://www.facs.org/news/obama081209.html

Then Obama essentially quit efforts at public support of Obamacare.

When a team of Republicans went to the White House to try to draft a better bill, Obama was not really engaged.

Obama signed Obamacare, but he had next to nothing to do with getting it passed.

Obama didn't have to work to get Obamacare passed: Kennedy's old plan, Pelosi, Reid, Emanuel, and the Dem majority were enough. That's just the way it was.

The Democrats that controlled both houses of Congress made Obamacare happen.

How is this different from every President since and including Reagan?

It is different, very different. Obama avoids blame. He's terrific at avoiding blame. E.g., at Harvard Law, he was editor of the Law Review but didn't write anything so never got criticized for writing anything. In the Illinois Senate, he voted "present" some huge number of times and, again, avoided any blame.

Reagan? He got blamed for Iran-Contra. Obama's not getting blamed for NSA, Snowden, Benghazi, Morsi, Syria, etc.

Obama is uniquely good at avoiding blame.

Also Obama is uniquely good at pulling together a coalition with the technique I described.

Obama managed to avoid any significant role or blame for the response to hurricane Sandy. W seemed to be involved in responding to Katrina and then took everything that went wrong in the neck.

I like the remark in the movie Hunt for Red October: "I'm a politician which means that I'm a liar and a cheat and when I'm not kissing babies I'm stealing their lollypops. But it also means I keep my options open.". In other words, avoid taking a public position.

If a president has a vision or program he feels strongly about, then he will do all he can to push it, expend his political capital, and maybe get something done. But another approach is just to step back and keep fingerprints off things that might not work. In Obama's case, it also helps, maybe has been crucial, that long the MSM was on his side.

There is one point to his credit, and this seems to actually be his one and only priority: The Affordable Care Act. He realy stuck his neck out for this. And I think it is a laudable effort.

If Obamacare really is better for US health care and patients, both soon and long term, and not wildly more expensive, then fine with me.

I don't know how much Obama's for Obamacare: He has made lots of supportive comments, but he also claims to want to shut down the coal plants. He's going to do next to nothing on the second, so maybe on the first he's just spouting stuff. From his remarks that the American College of Surgeons shot down, I doubt that Obama really knows enough about US health care to like Obamacare very much.

For Obama "stuck his neck out", I don't see it. The bill passed due to the Dem majority in both houses of Congress and the pushing of Pelosi, Reid, and Emanuel, and from all I can tell Obama had little to do with it. Now that the bill is law, he can praise it.

As Obamacare, Obama's name got attached to the bill and the effort, but that was mostly just politics by people who don't like either Obama or the bill and similar to what was done with Hillary care because it was obvious that we shouldn't trust our health care system to Hillary. And nearly no one would really want to trust their health care to anything designed or implemented by Obama.

On the act itself, no doubt US health care could be improved. Just how to do that is a serious question. There is the academic health care systems analysis economic optimization planning community with Karen Davis, etc., but I've been too close to such academics and wouldn't trust them to hand me a band aid. Maybe what Switzerland, Singapore, Sweden have is better. It appears that lots of people complain about what England and Canada have.

I was for improving the US health care system, but when I saw the sausage making that resulted in Obamacare, I concluded that the hard work of designing a better system had not been done. E.g., I saw that what was proposed had been taken off the shelf from some work by Senator Kennedy's health care planning staff. Kennedy was dreaming; such dreams are a good way to kill patients and waste money.

My fear is that as Obamacare goes into implementation, it will seriously hurt US health care and millions of patients -- some soon, much more later. And as the IRS goes around plucking money from checking accounts, people might get torqued.

Pelosi's remark "got to pass it to see what's in it" may have a point: It may be that heavily what the implementation is will be from regulations written by rows, columns, and layers of paper pushers in some big building about 70 miles from the Washington Monument.

So, Obamacare will be implemented slowly. Maybe as problems become obvious and people scream, the paper pushers will modify the system. I hope so. Due to the slow implementation, there will be some time to modify the system as it is implemented.

Here is some of what I suspect will happen. In the short term, people won't like the changes if only because they are changes. Then people will really not like the role of the IRS. In the long term, I suspect that a lot of the best people and companies will leave health care and, then, quality will fall. Getting the quality back will be super tough. I suspect that the flow of new, advanced, powerful biomedical products -- drugs, devices -- will greatly slow. I believe that a lot of seniors will get much worst medical care. The Palin image of "death panels" is not really wrong.

US health care is a patchwork system pulled together piece by piece over nearly all the decades of modern medicine. In some ways, the system works great, likely the best in the world. In some other ways, it's not very good. So, improvements are possible. But improvements are not going to be easy, that is, without damaging a lot that is good or spending too much money.

My fear of Obamacare is that it was mostly just a political football and from nothing like a serious effort to design a better system. Instead, the political part was, really, just the Kennedy dream, a dream of 'good health care as a basic right for everyone' or some such essentially socialistic notion. Pelosi? She wants more socialism from a bigger government. With Obamacare she was as happy as the lead high school cheerleader just named Homecoming Queen. The political part is that Pelosi took the old Kennedy dream and pushed it through, that is, pushed through that the US is on the way to socialized medicine. So, in the US socialized medicine is now a fact that will be difficult to change.

That's what Pelosi wanted -- the principle of socialized medicine, that the Federal Government is directly responsible for the health care of everyone. Just what the details will be and how it will work, Pelosi didn't care. Instead she will let the Executive Branch iron out any winkles and have Congress modify the law in places if necessary. But what she wants is socialized medicine; she's confident it will be better. So, again, especially to Pelosi, Obamacare was politics, that is, socialized medicine, socialism, having the central government directly responsible for each person's health care, and not really about how to design a better health care system. Good, bad, or otherwise, Pelosi wants socialized medicine and just trusts that it will be good.

Socialism keeps being attractive; has been around the world for about 100 years. Some of the attractions are that everyone gets together, joins hands, sings Kumbayah, and sets up the central government as responsible for some aspect of their financial, material, etc. security. They assume that, with everyone joined together, the idea can't fail. So, no more rich people, no more poor people, everyone just the same and good. The sales pitch has worked off and on seriously for about 100 years. That's what Pelosi wants -- socialism. She's a true believer.

Mostly people who try socialism find that it's darned expensive -- have the central government spending ballpark 50% of GDP and doing the spending as politics and, thus, inefficiently. The Thatcher remark was "The problem with socialism is that eventually you run out of other people's money". In the USSR the workers concluded "They pretend to pay us, and we pretend to work.". Russia finally totally gave up and went back to a wild west show. East Germany got rid of socialism ASAP. France keeps struggling with high costs, slow economic growth, high unemployment.

Switzerland? It's wealthy with a lot of healthy people. So, they have a shot at pulling off socialized medicine. The Scandinavian countries? They are big into socialism and are accepting their central government spending ballpark 50% of GDP. Also the countries are small and culturally homogeneous, and where they are not so homogeneous recently they have been encountering big problems.

In the end I believe that you will discover that Obamacare is really not about health care, really is a threat to good US health care, and really was and is about politics, in particular, some of the dreams of socialism.

One of the dreams of socialism is a basic income for everyone with an opportunity for more for anyone who wants to work for more. Fine with me except for one little point -- arithmetic. So far in the US, it doesn't add up. That is, productivity is not high enough. Instead, it is still the case that for the productivity the US needs to keep the cars moving and the store shelves stocked, the hospitals and schools working, the software written and the Web sites up, etc., some people have to work darned hard and with the "basic income" provided wouldn't. So, we still need the motivation of free enterprise. Hopefully with more robots we will have enough productivity to make the arithmetic work.

I believe that, as health care, Obamacare gets a grade of D- for its design work, that it really is not about health care but is about politics, really a socialistic dream of Pelosi; I believe that socialism won't work yet in the US, and the Obamacare, due heavily to its bad design work, will both in the short term and especially in the longer term seriously hurt US health care. My prediction is that as people scream, Obamacare will just get repealed. For Obama, he will likely be out of office then!

Reagan? Now I remember some of what he pushed with his political capital: He called the Soviet Union an "evil empire" and stood at the wall in Germany and said "Mr. Gorbachev, tear down this wall.". Then he pushed 'Star Wars' hard, had Ed Teller in the Oval Office explaining nuclear powered, orbiting X-ray lasers, etc. During his campaigning and his many rubber chicken talks for GE, he kept saying how important it was to have a balanced budget, but in office he told Stockman to "spend". And he spent big time on the US military. So, we got a lot of Abrams M-1 tanks. Leaders in the aviation parts of the US military were expected to fly and got their personal plane to fly, e.g., an F-16. When Reagan negotiated with Gorbachev in Iceland, Reagan would not give up on 'Star Wars' -- he was pushing hard.

The difference is, Reagan had an agenda and used his political capital to push things. It's not clear what political agenda Obama has, beyond making the Federal Government bigger and richer to enable more on social justice, and he essentially never pushes anything.

During the Reagan Admin, my wife and I were doing some consulting, and there was an issue in healthcare: The previous administration figured that if reduce the number of hospital beds, then will reduce the cost to the Federal Government for healthcare. So in each US county, etc., there got to be fights, with lawyers, for the available number of beds. I was involved as an expert witness on the statistics of how many beds were needed. Then Reagan came into office and right away cut out the group trying to regulate the number of beds; that was just part of Reagan wanting smaller government. Yup, I lost that part of my consulting business!

Maybe one likes Obama better or Reagan better, but there are differences!

The best the Federal Government does is terrific stuff -- NSF, NIH, DARPA, TVA, FAA, FDA. Otherwise I figure that any money the Federal Government doesn't spend it doesn't waste; any program it doesn't pursue does no harm. So, I'm for a more limited Federal Government.

Then in a sense I should like Obama because from all I can see actually he isn't doing much, that is, is concentrating on his golf game and jump shot.

He is spending a lot of money, but likely the economy still needs that. Otherwise I suspect that the next president will have lots of places to cut back.

Oh, by the way, we should not miss that mostly or entirely, Obama has never had a Federal budget! So apparently he just spends money, and when he runs out Congress gives him some more.

One effect may be that starting in 2016 real estate prices within 200 miles of the Washington Monument will head for the floor, e.g., from DC beltway bandit body shops no longer paying GED employees up to $200,000 a year. That area is now the third richest in the US, behind Silicon Valley and the hedge fund area of CT. I suspect DC's going on a diet, especially as interest rates start to rise!