Obamacare was supposed to be the capstone in the arch of a new progressive era. The Dems were going to show us all that government really does work. Smart government by smart people, using modern methods and the latest up to the minute research from carefully peer reviewed articles in well regarded social science journals can solve big social problems. Obamacare was going to be such a big hit that even the bitter clingers would have to put down their guns and their Bibles long enough to thank the Democrats for this wonderful new benefaction.
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It is a perverse but very real fact of life that the more complex and rich the system to be regulated, the less the "experts" and the goo-goos have the political power to impose their vision on the regulatory process. The more carefully crafted a law needs to be, the more it is going to be full of lobby lollipops and sweetheart deals. A legislative body trying to write a health care law for a country like ours is like a neurosurgeon operating, drunk, with one hand holding a chainsaw and the other in a boxing glove.