What's generally termed Obamacare wasn't the brainstorm of President Barack Obama, but an "Alice in Wonderland" "witches brew" concocted in 2010 by Senate Majority Leader Harry Reid and then House Speaker Nancy Pelosi with generous advice from Big Pharma, Big Insurance and the AARP.
All three groups stood to make billions off a convoluted bill that added 19 million potential new customers to the nation's health-care system, but hardly anyone in the Democratic majorities that rammed the bill through Congress had any idea what the legislation actually contained.
As Pelosi famously said on March 9, 2010, "We have to pass the bill so that you can find out what is in it."
Now Democrats are finding out key sections of the law may contain the seeds of its own destruction.
One of the most glaring examples is the requirement that uninsured Americans under 40 - who currently constitute some two-thirds of the nation's uninsured - must enroll in the new program, paying annual amounts averaging $3,000 or more depending on income for a full range of services that most don't want and very few need.
The Affordable Care Act contains age-rating rules that allow the government to impose premium cost on younger participants of about 3-to-1 to help pay for the oldest group, which consumes about five times as much medical care as the under-40 group.
Why would mostly healthy younger Americans pay thousands of dollars more for health insurance loaded with coverage they don't need when they can opt out of the system by paying a $95 fine and then - if needed - purchase catastrophic insurance for one-tenth the price of ACA coverage?
The question more than answers itself, but the overall key to the puzzle may be Obama's popularity with the under-40 age group. Enough of them may decide to sign on and pay full-freight because they believe in other aspects of Obama's second-term agenda - such things as withdrawal of U.S. troops from Afghanistan and better treatment of gays and minorities.
If Obama can't persuade enough younger Americans to sign up, the so-called signature legislation of his first term may collapse.
If that happens, progressive Democrats should step forward and make their case to the American people for a single-payer system. They have a strong case to make - supported by thriving single-payer systems the world over, including countries such as Canada and Germany with full-throttle economies.
Much of the waste in our current health-care system comes from higher administrative costs and the exorbitantly higher prices Americans pay for prescription drugs. One study estimates that the U.S. pays 31 percent for administrative costs compared to the 16.7 percent that Canada pays to run its highly popular universal, single-payer system.
The Affordable Care Act has some provisions aimed at reducing costs, but the overall task borders on Herculean in a system where hundreds of private insurers will still find it profitable to avoid paying for the sick and injured, and concentrate on finding healthier groups of people to insure.
Numerous other studies show huge savings would come from allowing the federal government to purchase prescription drugs in bulk from pharmaceutical companies. But Congress - swayed by campaign contributions - has always balked at this common-sense approach.
It would be foolhardy to rule out the possibility that large numbers of Obama's younger supporters will step forward and enroll in the Affordable Care Act.
If they don't, however, other enticing alternatives are available - ones like Vermont's pending single-insurer system that covers everyone - similar to the federal Medicare program for Americans over 65.
According to a recent article in the New England Journal of Medicine, Vermont's program will save a whopping $122 million in administrative costs by 2017. That is a huge saving for a very small state, and savings obviously would be much greater for larger states.
Wayne Madsen writes for onlinejournal.com.