Democrats bristle at the notion that Obamacare is the president’s Iraq War. Nevertheless, the similarities from implementation failure to misrepresentations (intentional or otherwise) to belated recognition things aren’t going as planned to the abandonment by his own party to reticence to publicly acknowledge error bear an uncanny resemblance to George W. Bush’s plight. Bush turned things around with a lonely and valiant decision to back the surge, but this president seems lost and trapped in a web of his own falsehoods and Rube Goldberg-like architecture.

President Obama (Carolyn Kaster/Associated Press) President Obama (Carolyn Kaster/Associated Press)

Are there lessons to be learned from the Bush second term?

The most important is to realize that your current crew is not up to the task and has fed you a steady diet of misinformation. Bush sacked his generals. Obama would do well to replace those who screwed up with new faces. Other than isolate the president and preside over one policy disaster after another, what have chief of staff Denis McDonough and adviser Valerie Jarrett accomplished? The president made his own bed by selecting second-term personnel who were loyal but not up to the task. He would be wise to go for quality and people outside his inner circle.

Next is to recognize when the premises of your policy objective aren’t true. Bush learned that he needed a whole new approach to Iraq — political stability would follow security (not the other way around), more troops were needed and the military had to provide sustained protection to the civilian population. Everything he had been told — a light footprint, focus on the political process — was wrong, and he had to go outside those who devised the failed strategy to win the war. If Obama is going to save health-care reform, he’s going to need to rethink his premises as well. Young people aren’t flocking to the exchanges. The governors didn’t all expand Medicaid. The insurance cancellations have created a furor. What is his “surge”? His phony “tech surge” to fix the Web site is both insufficient and irrelevant (and apparently isn’t going to make the Nov. 30 deadline); he needs a new architecture for health-care reform. For example, work with governors to expand Medicaid in return for greater control over the program and look to high-risk pools to cover the hard-to-insure.

Finally, as Bush began to do in December 2005, Obama has to begin to address the country, acknowledge he’s not “winning,” express hope that the end goal can be met and eventually present an alternative. In short, he’s got to hit the reset button on his most important initiative.

Obama is not going to be able to keep Obamacare the way it is because it is failing. He can either see the entire thing collapse or change gears to salvage what he can. He has to realize, as Bush did in the second term, that like it or not, this issue will dominate all others and could likely result in a wipeout in the midterms. The idea he can turn to other things or regain his standing by making small progress in other areas is deeply misguided. And the notion that everything is basically fine is a delusion that threatens his presidency.