Self-evidently idiotic, he indicated at the summit, is the idea that health insurance might go back to being "the equivalent of Acme Insurance that I had for my car. . . . It's basically not health insurance. It's house insurance. . . .

"I'm buying that to protect me from some catastrophic situation; otherwise, I'm just paying out of pocket. I don't go to the doctor. I don't get preventive care. There are a whole bunch of things I just do without. But if I get hit by a truck, maybe I don't go bankrupt."

We won't unpack the assumptions in this rant: That the affluent, educated beneficiaries of this tax loophole aren't capable of spending wisely on their own health care.

Mr. Obama hereby chucks over the side virtually all creative thinking about our health-care predicament, not to mention the single worthwhile policy innovation of the past two decades, the health savings account. In an unwisdom that he will probably come to understand only in his later years, Mr. Obama wastes the umpteen months his predecessor spent stumping the country for HSAs as a way to give consumers some financial "skin in the game." It was a theme voters could grasp because it made sense, unlike the Rube Goldbergism of Mr. Obama's health-care plan.

This week even Warren Buffett called the Obama plan "2,000 pages of . . . nonsense," adding, "The problem is incentives."

Here, Mr. Obama squanders the opportunity his presidency represented. For it's entirely possible to visualize incorporating this insight about the proper role of insurance with a system of guaranteed coverage and individual mandates à la ObamaCare, and indeed back when Mr. Obama was believed to be smart, we would have guessed this was the direction in which he would head.

Like any real reformer, he would have challenged both parties down to their ideological socks. Republicans would have had to swallow a universal mandate in return for an across-the-board tax cut to compensate workers for loss of the health insurance loophole.

Mr. Obama says he's content to be a single-term president. The soonest, then, we can hope for real progress on health care is three years.

His failure calls for some historical perspective. An enduring mystery is why Jimmy Carter insists on preaching about foreign policy when his real achievements were in the realm of domestic deregulation. OK, the ideas were hatching away in the back of the Nixon administration, brought forward by Ford and continued into Reagan's first term with the defeat of inflation and passage of the 1986 tax reform.

But altogether it was a period of the greatest domestic policy innovation, based on a profound bipartisan learning about the defects of what went before, namely 90 years of the "Progressive" regulatory urge.

Mr. Obama is turning out to be Jimmy Carter on foreign policy, but he's no Jimmy Carter on domestic economic policy.

In fact, he's turning out to be exactly what you fear getting when you elect a glossy unknown: a gift to the world (in his own eyes) with no real grit.

It's going to be a long three years.

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