The worst wounds politicians suffer are usually self-inflicted. Nixon had Watergate, Clinton had Monica Lewinsky, Reagan had Iran-Contra, Bush 41 had “read my lips” and his son, Bush 43, had Katrina and Iraq.

And now it’s Barack Obama and “if you like your insurance plan you can keep it.”

He’s the latest and most visible victim of self-inflicted wounds, and this one could prove fatal to his presidential legacy. Last year’s presidential election was rife with examples, particularly on the Republican side.

A parade of hopefuls became frontrunners du jour – Herman Cain, Rick Perry, Michele Bachmann, Tim Pawlenty, Newt Gingrich – only to quickly shoot themselves down.

Mitt Romney’s ambitions suffered a potentially fatal wound when someone released a video of the GOP nominee’s infamous candid 47 percent remark at a private fundraiser with fellow multi-millionaires.

Romney made repealing the Affordable Care Act (ACA) a top target of his 2012 campaign, and Obama interpreted his victory as an endorsement of the program, but the GOP has carried on the attack campaign into Obama’s second term.

House Republicans have passed more than 40 bills, amendments and resolutions and even shut down the government for 16 days at a cost of $24 billion to the US economy in repeated failed efforts to kill Obamacare.

They held funding for the federal government hostage to their demand that Obama agree to drop his signature legislative achievement.

Instead it was the Republicans who ran up the white flag, but not before doing enormous damage – not to Obama and Obamacare but to themselves.

Republicans are talking about repairing Obamacare, but they’re not being honest. Speaker John Boehner (R-Ohio) and Rep. Fred Upton (R-Michigan), chairman of the House Energy and Commerce committee and author of the so-called “repair” bill that passed the House on Friday with 39 Democratic votes, admit that repair is the last thing they want.

When CNN’s Jake Tapper asked Upton whether his bill wasn’t a “Trojan horse” because he really isn’t interested in repairing Obamacare, the congressman admitted, “There’s not a Republican out there who wouldn’t want to repeal it.”

But don’t blame the Republicans for what went wrong; all their efforts to damage and destroy ACA have failed, sometimes, like the shutdown, with disastrous consequences for them.

What has Obamacare bleeding and in the ICU are self-inflicted wounds.

Those include a dysfunctional White House decision-making process that spurns help from experts, rank incompetence among the high level bureaucrats charged with implementing the new health care plan, a wholesale lack of accountability at high levels and a president bizarrely aloof from even the most basic details of what he expected to be his signature accomplishment.

The Republicans argued from the outset that Obamacare wouldn’t work and would in fact make health care worse for many Americans; incredibly, the Obama team seemed determined to prove them right.

Millions of Americans feel – not unjustifiably – that they were lied to. Obama and company have set back the critical cause of health care reform by years.

The president’s pitiful performance has affected every other area of US policy – at home and abroad. It is not a stretch to say US credibility in the Middle East has suffered because of the self-inflicted image of incompetence and weakness created by the health care fiasco.

The crisis has amplified the impression of confusion and disarray in Obama’s Middle East policy.

The United States looks weak and ineffective as turmoil spreads in Egypt, Libya, Iraq and Syria. US-Israel relations, after a brief uptick earlier this year, are again in the pits as Prime Minister Binyamin Netanyahu accuses the administration of being overeager to cut a nuclear deal with Iran.

Making matters worse, the Saudis and some other Gulf Arabs are siding with Israel on this one.

Obama has failed to enact top legislative priorities like immigration reform and gun safety. The administration is haunted by IRS targeting of conservative groups, Justice Department tapping journalists’ phones, the Snowden gusher of leaks and revelations about NSA snooping on foreign leaders.

Obama can’t be blamed for all that, but it has happened on his watch and, as he likes to quote Harry Truman, his desk is where the buck stops.

The administration has been shuffling staff to try to get the ACA website and sign-up working, but so far no one is being held accountable, and no one has lost their job, even though officials admit they won’t meet their latest deadline to get it fully operational by month’s end.

Meanwhile, Barack Obama is left out there twisting slowly, slowly in the wind, suffering from the damage done to Obamacare and his presidency with no one to blame but himself.

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