LyrArc Article Gist
Obama Affordable Care Act ACA and its downfall are covered by two experienced authors over 2 book written over 2 decades. The authors are James Morone and David Blumenthal followed the healthcare issue over 25-30 years through the Clinton, Edward Kennedy and Obama efforts and wrote two books. The first was "The Heart of Power" on the healthcare situation from FDR to 2008. The last titled "Whiplash" in 2026, for which the authors are interviewed in Harvard Medicine magazine. C-SPAN has a book program on this book at a Washington DC bookstore. From the discussion on C-SPAN between Senator Michael Blumenthal, borther of one of the authors, James Morone and David Blumenthal physician, couple of conclusions are seen that may be new to readers.
Q. What was the one single factor that doomed the Affordable Care Act?
A. The deep antipathy towards the Obama administration influenced the response to the Obama handling of healthcare. The likelihood of Republicans accepting healthcare from a black person was simply not there say the book's authors in the discussion and Q&A on C-SPAN. Yet there were other reasons for the ACA failing. Obama had not gauged the mood of the nation well. UK Labour's Starmer won by a big majority in 2024 yet that does not reflect the mood of the British nation just 2 years later- by election year 2012 Obama's campaign was faltering and had to be rescued with Hispanic votes and a weak candidate in Utah's Mitt Romney. Obama lacked maturity and came in the way Bush came in when the list of candidates were mediocre in the US, similar to the period in the UK with David Cameron and Boris Johnson. To take on the health care issue required someone with the experience and caliber of LBJ, which Obama clearly lacked, coming from the minority community was not going to help in credibility. Obama's presidency was thus premature and to gain experience he would have done better in a key cabinet position such as at Department of State where an intellectual could have influenced world opinion in favor of emerging countries, a doable and necessary. Obama's lack of experience showed when he told Republicans two words in the first months in 2008- "We Won," perceiving arrogance it would set Republicans against him. The years 2008-2016 cost the US dearly in that the US needed a withdrawal from all of the Middle East which would require a strong president with deep roots of support in all parts of the country including the south, to avoid recriminations. In the end by continuing the wars Obama weakened the US and let China move ahead.
Q. Did Obama consider Medicare for All?
A. Obama told Congressmen of his party according to Morone- if you can get 60 votes in the Senate for Medicare for All we can try.
Q. Would it take a major upheaval for Medicare for All to be accepted now that the health system is failing all Americans in 2026?
A. It will take a world war or a economic depression- some major disaster for Medicare for All to be accepted in the US, say the authors. A pandemic happened in 1918 and again in 2019 the results were not positive, as the authors believe it unleashed the war on science after the vaccination for and against camps, leading to the culture wars in America seen today.
Q Obama's analytical mind thought he learned from the Clinton efforts in healthcare that failed. But he did not see things from the heart. There is good reason to think that the lessons learned of moving fast, letting Congress write the legislation, settling for what can be done not what needs to be done, were exactly the wrong lessons to be learned as opposed to writing off the Clinton experience entirely as Clinton's, and starting from scratch without preconceptions. In the end Obama if he was older, had more experience, and listened to the mood of the country would have realized that healthcare was for another day, and got right down to the most difficult challenge, to end the wars in the Middle East. Even small steps in the right direction would still have earned appreciation him today. Instead Bush and Obama, the most inexperienced of presidents will be remembered for wars they continued that weakened America.
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