It's Christmas. Barack Obama is shown sitting on the sofa next to Uncle Sam. The President has just given Sam a present - a badly made wooden box labelled 'Obamacare' filled with all sorts of medical equipment. Obama tells Sam, "I made it myself!" Uncle Sam's reaction is one of horror.
The cartoon is a nod to the trend for homemade Christmas presents. The problem is that Obama's gift is a complete mess (just like the botched Obamacare rollout). However, Obama seems quite proud of his offering, reflecting the fact that he was the architect of the health reform which bears his name. Note the drone on Obama's jumper and the listening devices in the Christmas tree - references to two other controversies which have dogged Obama's presidency in 2013.
The reflexive pronoun 'myself' is used here to emphasize that Obama made the present alone without any help. With this meaning the reflexive pronoun is often preceded by the preposition 'by'. • She prepared the whole meal by herself.