It did derail the Democratic agenda, but mostly because Republicans made it their mission to ensure that Obama was a one term President. That has been policy ever since, and effectively zero legislation has come out of Congress since.
Democrats did manage to finesse the sole legislative accomplishment of the last couple of decades, the Affordable Care Act. In a lot of ways it was a fairly trivial change to the health care system, but getting anything passed at all was, in the Vice President's words, "a big [effing] deal".
It feels that way, but let's remember that Republicans have held the governorship in Massachusetts for most of the past 30+ years. That's an interesting broader phenomenon, though. A number of other states have turned reliably blue in congressional and presidential elections while voting in Republican governors. New Hampshire is like that, and I was recently surprised to learn that Vermont is too.
Those Republican governors in blue states try to run as "old fashioned" conservatives, more about economic policy than culture war. It can work within the state but less well when the national platform is at stake.
The provisions for moving beyond paper was one of the biggest, and most relevant to people here. Examples are the use of electronic records, the incentives to actually use them (both for patents and for metrics), etc.
Due to the market power of Medicare, it also changed payments from per procedure to per outcome.
Many of these changes were quite deep. I would not use trivial to describe it.
Within that framework the changes can be seen as significant. But that framework is widely despised in the US and considered insane everywhere else.
"More people died at Chappaquiddick than at Three Mile Island."
On the "October Surprise" topic that other posters have asked for more information about -- it's a fascinating story that ultimately leads to the Iran-Contra scandal:
Here's a transcript of a 1987 broadcast by The Other American's Radio about the October Surprise:
https://www.donhopkins.com/home/catalog/text/october-suprise...
And a paper I wrote about it in 1988 for a university writing class, with lots citations to sources I looked up in newspaper microfilm archives (what researchers had to do before google and youtube and wikipedia were a thing), plus a couple links at the end I added later when I transcribed it to html, once the world wide web existed:
https://www.donhopkins.com/home/documents/OctoberSurprise.ht...
Here's my criticism of Carter's response to the hostage crisis, and a description of the failed hostage rescue mission that Oliver North, Richard Secord, and Albert Hakim sabotaged, years before they caused the Iran Contra Scandal by trading arms to Iran for money and hostages, then illegally channeling the money to the Contras:
>III. Carter's Response
>From the beginning, President Jimmy Carter gave the hostage crisis a high profile. It was the focus his and his country's attention, day after day. But that was exactly wrong approach to take if he wanted to get the hostages out, without making it seem like he conceded to terrorism. Not only did the Iranians benefit from the publicity, but the constant crisis took time away and attention from other important problems, like the Soviet invasion of Afghanistan, and the 1980 presidential election.
>What Carter should have recognized was that there were different factions in the Iranian government competing with each other for power, and the hostage situation would go on as long as the Iranians could use the situation to their political advantage. If there was not as much attention on the hostage crisis, it would have not been as useful a propaganda tool.
>The President threatened a military response if the hostages were harmed or put on trial. The threat was deterrent, not coercive. Such threats are most effective at keeping somebody from doing something they haven't already done. The threat worked. Iran stopped saying they were going to put the hostages on trial and execute them.
>Carter considered several courses of military action. He decided not to mine Iranian ports, as that would interfere with other countries, and might provoke the Iranians to harm the hostages. He did however order that a rescue plan be drawn up, but he hoped it wouldn't have to be used.
>The other effective measures he took were to freeze Iranian monetary assets, and to impose an arms embargo and economic sanctions. His goal was to get other countries to go along with the embargo and sanctions.
>IV. The Hostage Rescue Mission
>On April 23, 1980, an abortive Iranian hostage rescue mission took place, conducted under the utmost secrecy. The plan was to storm the American embassy in Tehran, and bring home the hostages.
>8 helicopters, 6 C-130 transport planes, and 93 Delta force commandoes secretly invaded Iran. They were to rendezvous at a place in Iran they called Desert One, move out to another point called Desert Two, and then go on to Tehran to rescue the hostages. But Delta force never made it to Desert Two or Tehran. The mission was aborted after three of the eight helicopters failed, on the way to Desert One. The operation was a miserable failure, resulting in an accident that caused the loss of 8 American lives. Later investigation revealed a surprising level of negligence. [4] [7] [13]
>Just before the rescue mission took place, several other countries had finally agreed to level economic sanctions on Iran. Some of them agreed to the sanctions because they thought that if they did, the U.S. would not take any military action. They were quite irate when they heard about the rescue mission after the fact.
>At least three central figures in the Iran-Contra Scandal were involved with the Iranian hostage rescue mission: Secord, Hakim, and North.
>General Richard Secord helped to organize the abortive rescue mission. After the first mission failed, he was the head of the planning group that eventually decided against another rescue attempt. Because the whereabouts of the hostages were unknown, the second rescue attempt (the October Surprise that the Reagan-Bush campaign was so worried about) never happened.
>Secord was later suspended from his Pentagon post because of the EATSCO probe. EATSCO is a company that belongs to Edwin Wilson, the CIA operative who is currently serving time in a federal maximum-security prison for, among other things, secretly supplying 43,000 pounds of plastic explosives to Kadaffi. [21]
>In 1981, he became Chief Middle East arms-sales adviser to Secretary of Defense Casper W. Weinberger. [21]
>Albert Hakim is a wealthy arms merchant, an Iranian exile, and CIA informant, who had a "sensitive intelligence" role in 1980 hostage rescue. He worked for the CIA near the Turkish boarder, handling the logistics of the rescue mission in Tehran. Hakim purchased trucks and vans, and rented a warehouse on the edge of Tehran to hide them in until they were needed for the operation. Unexpectedly however, he skipped town the day before the rescue mission. [2] [13] [25] Later on, in July, 1981, Hakim approached the CIA, with a plan to gain favor with the Iranian government by selling it arms. [22]
>Oliver North led a secret detachment to eastern Turkey. He was in the mother ship on the Turkish border awaiting the cue from Secord to fly into Teheran and rescue the hostages. [2] [25] After the first aborted rescue mission, he worked with Secord on a second rescue plan.
>According to the October Surprise theory, Secord, North and Hakim did not intend Desert One to carry through. The miserable failure of Carter's Desert One rescue attempt may have been deliberate.
[More intriguing details about the sabotage, election, Iran Contra Scandal, and citations in the full paper: https://www.donhopkins.com/home/documents/OctoberSurprise.ht... ]
As someone who remembers that era, I'm not entirely sure I agree with that. I don't think Carter himself made it high profile as much as the media did. The ABC News show Nightline started then as a nightly report on the latest in the hostage situation. Every night it would start with "Day XYZ: America Held Hostage!" (where XYX had been the number of days. The Right wanted Carter to bomb Iran "back into the stoneage".
As for the rescue attempt, there were significant problems including equipment failure - new helicopters that weren't really battle tested, for example (this led to a lot of soul searching as to whether there were problems with military procurement, for example). Yes, Carter probably shouldn't have agreed to it.
A former neighbor's dad was one of the hostages, and he has a photo from the reception that Reagan hosted at the White House for them.
[0] https://en.wikipedia.org/wiki/Operation_Eagle_Claw
[1] Yes, that Sullenberger. The Airbus A320 from the Hudson is on display there. https://en.wikipedia.org/wiki/Sullenberger_Aviation_Museum
That aside, when I read about downsides of universal healthcare in America, I still think the tradeoff is worth it. Even if it means wait lines and decades slower drug discovery, if it meant measurably less rage at the system, I would support it. I know this isn't the thread topic, but the public polled reactions to literal assassination being not particularly negative points to how unpopular the current system is, despite other measures showing it as popular.
Anyway, screw the (political) Kennedy family. Seriously.
[1]: https://en.wikipedia.org/wiki/Chappaquiddick_incident