To fans and defenders of the Affordable Care Act, the bill is your normal, run-of-the-mill but wholly fantastic and wonderful game-changing measure, up there with Social Security, Medicare and the Civil Rights and Voting Rights Acts as national milestones — bills that were launched amid opposition and discord, but in time were accepted and loved.

But from the beginning, this has been different in three signal ways that have been self-destructive, the last of which may be the worst.