That his wife spent her legal career battling insurance companies and knew all their tricks was a big reason for chants of "two for the price of one" and that had a lot more than nepotism to do with her writing the Presidential healthcare plan (back then Presidents took an active hand in legislation they considered a priority. ) It wasn't the sole issue for Obama, but as support for Iraq waned among Republicans while Bush belatedly and tacitly conceded McCain was right we should go loaded for bear or not at all (with the effect one might expect, though he still didn't commit as much as McCain and the Chairman of the Joint Chiefs wanted in '03) healthcare along with the economy in general increasingly became the impetus of his campaign. Make no mistake, the already high and still rising cost of healthcare is very much an economic issue, and the tax and deficit hit we'll take addressing that pales in comparison to allowing healthcare to consume ever larger chunks of our GDP.

If you think being "not Bush" was enough to win an election you need to flash back to '04, when a month before the election Bush finished behind "another candidate" in one poll and behind "ANYONE else" in another. Kerry still lost, hence my joke that he finished fourth in a two man race. He didn't give anyone anything to vote FOR, and that made whoever could sling the most mud the favorite (always bet on Karl Rove under those conditions. ) As for Clinton, yes, Perots 20% of the vote hurt Bush, but if Clintons 43% wasn't a mandate for universal healthcare, does that mean Lincolns 40% wasn't a mandate for union? It's no different than the Deaniacs who played spoiler for Kerry, or the Naderites who sank Gore (who lost NH and the Presidency by <7000 votes, while Nader polled >3X that) or the McCarthy supporters who stayed home rather than vote for Humphrey. Heck, neither Bush NOR Gore hit 50% in 2000, so 43% in a race where a third party polls 20% nationally is a mandate. Obama was generally recognized to have a "mandate for change" but even with Omahas lone EV he was still 5 short of Clintons '92 total.

I hate to play the age card, but I probably do remember that election a little better; it was the first one I voted in and universal healthcare (which is definitely a kind of reform, but Dems back then had the balls to try to actually make a difference) was a top priority in my memory. It's been a Democratic platform plank since the end of the Second World War, but to our cost we failed to achieve it while the rest of the West succeeded, and as long as we continue to ignore it we'll continue seeing our living standard slip relative to theirs. Don't doubt for a second that was a driving force for both Clintons in '92; the difference now is that by ignoring the problem and demonizing evil trial lawyers like Hillary the problem has reached the level of a crisis in the interim. It's not going to get better if we keep ignoring it; that's not how crises work.