1. Barack Obama

Obama ran on a platform to enact the most sweeping health care overhaul in decades, and much of his focus in his inaugural year has been just that. Although some have criticized Obama’s decision to allow congressional leaders to take the reins in drafting the actual bills, there’s never been any doubt whose template they were following. And when hurdles arose (and there were many), congressional leaders were usually summoned to the White House, where the wrinkles were ironed out. If health care reform does become law next year, despite economic problems at home and national security problems abroad, it will be because of the president’s insistence.