It also doesn't get rid of their anti-trust exemption, leaving the effective monopolies in place. This leaves us open to continued abuses by the industry and fails to do the most important cost-cutting measure, cutting out the paper pushers who serve no useful purpose in the economy. But there is good in the bill, too, and one has to be a bit Hopey that over time demands by the public will make the bad and unpopular stuff less bad and less unpopular.

I'm trying to evaluate it on its merits rather than comparing it to what was never going to happen. The Atrios/BTD position sounds about right.

Case in point: My SIL is a single mom who currently has no dependents because they're both over 21, but is at the threshold of not getting subsidies, while still not being able to afford insurance. Besides owning a house upside-down that is a money pit, she just put two kids through college  and is paying off loans for private colleges for the next decade. (She's a bit of a sucker in regards to private versus public colleges.)   While she looks like she's okay financially on paper, she's dirt poor.  She plans to put the money she would have paid toward getting herself some healthcare every year toward the tax.  She doesn't plan to insure.

How many people out there are like her.  I'll bet it's more than a few.  And when premiums rise ridiculously because no cost controls exist but we're forced to buy insurance from a monopoly, then even more people will drop off.  I will drop off because it makes more sense to pay the tax and self-insure.

The Democrats have written their own path to destruction.  Was it the plan all along?  Do even they prefer one-party Republican rule?  Personally, I think it's kind of obvious that they do. Dionne might think so now too.

Now that it's done, Barack Obama will go down in history as one of America's finest presidents. [. . . F]undamentally, he's reshaped the policy landscape in a way that no progressive politician has done in decades.

But let's not forget there's a long way to go still.

I honestly see this as the beginning not the end.  Private insurance is not a sustainable model.  This bill will help the most vulnerable in the short term, but I also believe it will help expose the fact that there is no true reform based on the private model.

Basically in my mind the best case scenario is - the people who are most vulnerable get some assistance, and this bill sets up a system where in the future we can now say "we actually tried to reform the private model, it wasn't enough, time to go public".

Was public insurance possible at this moment in history - I think yes, but we didn't get it.  So I'll take what I can get, and lets continue working.

[. . . F]undamentally, he's reshaped the policy landscape in a way that no progressive politician has done in decades.

is certainly true.  1)  He's publicly reshaped the Dem party into a moderate Republican party and 2) as part of #1 he's taken abortion off of the political table by creating a more-or-less anti-choice Democratic party.

At the least he's certainly reshaped the abortion debate and the Dem platform.  He's very effectively served notice that, so long as Roe remains technically intact, Dems will happily enact anti-choice policies in service to other political ends.  

It seems very clear that "choice" is no longer a policy goal for Dems.  As far as Obama and today's Dem party is concerned, the status quo is the apotheosis of Dem efforts on women's reproductive rights and women's health care needs.