What’s the most damaging thing President Barack Obama has done during his six-year tenure in office? According to libertarian satirist P.J. O’Rourke, author of “The Baby Boom: How It Got That Way (And It Wasn’t My Fault) (And I’ll Never Do It Again),” it’s precisely the piece of legislation Obama considers his seminal achievement.

“Oh, Obamacare,” O’Rourke said. “Not because that in itself it’s such a bad idea, but it’s a such sloppy piece of legislation, and it just puts the — well, it doesn’t put the camel’s nose in the tent; it puts the whole damn camel in the tent. We brought the federal government into a situation where it’s just not going to help. And you cannot — once you create an entitlement program, it’s just impossible to get rid of, no matter how badly it works. It’s very, very hard to get rid of these things or even modify them in any significant way. Clinton and Gingrich managed some element of welfare reform, but a lot of those reforms have been nibbled away at since, so the problem still persists.”

Liberals accusing Republicans opposed to Obamacare of wanting Americans to go without health insurance are making a category error, O’Rourke said.

“Creating a whole new category of entitlements was really a disastrous thing to do,” O’Rourke said. “This is leaving aside a judgment about whether this is the right thing to do, whether entitlements do good or whether these entitlements are needed — we cannot, in our present economic structure, afford a new damn entitlement program, be it however wonderful.

“That was one of the great things about Bill Buckley,” O’Rourke continued. “When Bill Buckley was — when people would bring up universal health care, Bill — instead of arguing with them — would go, ‘That’s a nice idea. A nice idea.’ Obamacare was a nice idea.”

According to O’Rourke, Republicans working to defund Obamacare during October’s partial government shutdown were fighting a lost cause — the opportunity to repeal the law is behind them. The health-care revolution was, and instead of correcting a few flaws in the regulatory scheme, the government created a new class of entitlements.

“It’s here to stay,” he said. “We’ll have to adjust it so we can afford it, but it’s going to be really painful when we do that. If we had nipped this thing in the bud or come up with something far more sensible — I mean, the idea of an insurance marketplace is not a bad idea, but that would have been pretty easy to do to knock down the barriers between states to do a nationwide… to improve the free market. was there a need for catastrophic health care for people who fall between two stools, who don’t qualify for Medicare but are going to be beggared by their health bills? We don’t want to see anyone beggared by their health bills.

“No Americans wants to see somebody lose their house because of health bills. Their boat? Maybe,” he said with a chuckle. “Maybe the boat. But not the house.”

Insolvency problems with existing programs, such as Medicare and Medicaid, could have been solved by asking recipients to repay a small portion of the payments they received.

“[T]hey could have been essentially paid for by making sure everyone on Medicare and Medicaid had skin in the game. I’m on Medicare now. If I go and have a big operation, it costs me nothing. It should cost me a little. I’m not rich, but I can afford a few grand if I have to have my appendix taken out. I can pitch in a little bit.”

Catch the rest of TheDC’s featured segments from the exclusive interview with O’Rourke this week.

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