His early insistence on bipartisan approval left health reform hostage to those who opposed it. His refusal to articulate a clear vision allowed enemies of reform and their friends in the lunatic right to define the issue in their own terms – as a plot by Nazis to institute death panels.
Most of all, his own lack of clarity has crippled his efforts. Obama wanted to present health reform as a measure that would expand medical coverage to all, while costing Americans less. Yet he deliberately foreclosed the only options – single-pay insurance and pharmaceutical bargaining – that would have allowed him to achieve those competing aims.
That some of Obama's plans might work sometime in the future is possible. That up to now few have succeeded should come as no surprise.
Clearly, Obama cannot be blamed for everything.
He did not invent the recession, the mortgage meltdown, the North American auto crisis or the global financial collapse.
By committing vast amounts of federal dollars to fight the recession, he followed not only the new international orthodoxy but almost certainly the correct path.
Yet even here, the president's debilitating caution came through, particularly in his reluctance to comprehensively tackle the core of the problem, America's bloated and dysfunctional financial system.
Instead, Obama and his treasury secretary Timothy Geithner focused on fixing that system just enough to let it resume those practices – such as issuing complex asset-backed securities – that caused the economic crisis in the first place.
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