Incremental change is often counter productive. Major change requires major problems because people are inertial. Picture things as a number line. 0 is somethin

Incremental change is often counter productive. Major change requires major problems because people are inertial. Picture things as a number line. 0 is something 100% beneficial to society at expense of special interests. 100 is something that is 100% beneficial to special interests at expense of society. Major changes, such as single payer healthcare, require major action and major support. It's highly controversial and would require a massive rethinking of an enormous amount of our society - and all at substantial risk to many people. To get this sort of action you need people pretty far along that number line - perhaps at 85 - to drag people out of their naturally inertial state. And indeed it may have been the case that before the ACA people were starting to reach into the 90s. What has the ACA done? It's certainly a very flawed system and that's seen, arguably predictably, skyrocketing premiums (an average 25% increase in premiums in 2017 alone [1] ) and other more systemic issues such as rapidly decreasing competition. But it's better than what we had before, even if just incrementally. But now instead of being in the 90s, our numberline on the 'fairness' of healthcare is now somewhere in the high 70s. Another way of looking at this is that the odds of something like single payer entering the political conversation, which was a very real possibility before, are now effectively zero. And this has been a recurring theme throughout many of Obama's actions. Of course this all begs an obvious question. Was he behaving this way intentionally to maximize the value of special interests, or was he just a well intentioned person trying to make progress in a difficult system? Given one of the first things he did after leaving office was to go give a private talk to a wall street firm on healthcare, for a $400k "speaking fee" - well... [1] - https://www.cbsnews.com/news/why-obamacare-premiums-are-rising-and-what-you-can-do/ https://www.cbsnews.com/news/why-obamacare-premiums-are-risi...