Consider health care. If any issue might suggest an Obama vision, this would be it. But what, really, is Obamacare? It is quite unlike Medicare or Social Security. Both programs—despite their shortcomings—are conscientious mixes of policy ideals and political realities, crafted by men with clear visions. Look carefully at both programs, and you can see that vision, not only of what the proper policy is, but how to get it through Congress and build public support.
Obamacare exhibits none of these qualities. It is a bizarre Rube Goldberg contraption with no clear idea at its core. The exchanges are intended to promote competition while the Medicaid expansion doubles down on single payer. It reins in the insurance companies while the risk corridor program shovels billions to them in bailout cash. It expands coverage for prescription drugs for seniors while simultaneously granting drug companies some exceedingly generous rents.It is almost as if it were written with no White House input except, “Get me a bill to sign!”