The little fact that people with my disease would be dead right now without ACA tends to cloud my judgement. I'm definitely not saying it's great, or even good, but it is saving people from early death and medical bankruptcy which is all that Obama and the Democrats could get at the time and ever since. How could they have done better? They simply did not have the votes in Congress.

You want a better system? Then vote for Democrats in 2020, because that's the only way "better" is going to happen. Even Centrist business-shill Democrats will make it better. If a third-party candidate gets enough of the progressive vote, Trump wins and everything gets worse. Not near bad enough for a revolution that reforms American politics. Just worse.