Charmion, you said " President Obama's obeisance to the insurance industry in the drafting of the Affordable Care Act amazed me then, and puzzles me to this day." Remember, presidents don't write bills, congress does. Presidents can state what they want and with a majority in both houses, which Democrats had at the time, he generally gets it. The problem was a handful of what was called Blue Dog Democrats. These were Democratic senators from red states (states that trend to vote Republican). The rationale is that if they seem to be too liberal it will be hard to get re-elected in those states. That was the excuse anyway but dig into it a bit and you will find that all of the so-called Blue Dogs had also taken at least a million dollars in contributions from insurance companies, large medical corporations and drug companies. It took nearly a year to hash out the Affordable Care Act and the infighting was between Democrats. The Repubs wanted no healthcare bill at all so they sat on the sidelines throwing brickbats. I remember a catch phrase from the moderates in the party that were becoming increasingly desperate to get a bill, any bill passed: Don't let the great get in the way of the good. We ended up with the mediocre.