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Getting Real About the Health Care Debate

(AP Photo/Charles Dharapak)
Remember the heady days of March, when the president hailed comprehensive reform as a "moral and fiscal imperative?" In the ten months since, the Democrats have been gob smacked repeatedly by reality - not to mention Joe Lieberman (and now, apparently, Ben Nelson) - leaving the party spin-meisters to celebrate what little remains of their once plan to reform American health insurance as a victory.

"To defeat a bill that will bend the curve on this inexorable rise in health-care costs is insane," Senior White House advisor David Axelrod said on MSNBC Thursday morning. "I don't think that you want this moment to pass. It will not come back."

That message du jour was echoed by former Clinton advisor and now CEO of the Center for American Progress, John Podesta, who authored a piece making what he said was the progressive case for passing the Senate health bill.

Yes, he allowed, the current bill has problems. Still, he believes it would "represent the most significant public reform of our health care system that Congress has passed in the 40 plus years I have worked in politics."

"The bill will give health care coverage to a record 31 million Americans who are currently uninsured, lay a foundation that will begin to lower costs for millions of families, and provide all Americans with the access to adequate and dependable coverage when they need it most."

Both men were trying to rescue the day's story line after former chairman of the Democratic National Committee Howard Dean, ripped the current Senate bill in an op-ed piece he wrote for Thursday's Washington Post. op-ed (You know that when one of the Democratic Party's insiders dismisses the bill as doing "more harm than good to the future of America," that's bad news in bells.)

A few comments on the situation:

* Iowa Republican Charles Grassley was depicted as a goober after he endorsed the goofy fiction about government apparatchiks ready to snuff out grandma. Same for the likes of Jim (Waterloo) DeMint of South Carolina and Oklahoma's James Inhofe, among others. OK, their antics make for yuks on YouTube videos but these folks undeniably are superb at firing up the conservative base and unifying Republican opposition. Their unyielding opposition to health care reform has denied the Democrats a legislative victory and at this 11th hour one wonders whether the Democrats underestimated their opponents.

* As the legislative process gets dragged out, the increasingly attenuated health care bill becomes less and less attractive to the left. That's also left some Democrats with buyers remorse. Liberal activists who were infatuated with Barack Obama during his primary run against Hillary now feel betrayed because their magic prince turned out to be, well another skilled politician and one who makes compromises. Welcome to the real world, folks. As Glenn Greenwald notes, this outcome was "painfully predictable" from the beginning.

"We've long heard -- from the most blindly loyal cheerleaders and from Emanuel himself -- that progressives should place their trust in the Obama White House to get this done the right way, that he's playing 11-dimensional chess when everyone else is playing checkers, that Obama is the Long Game Master who will always win. Then, when a bad bill is produced, the exact opposite claim is hauled out: it's not his fault because he's totally powerless, has nothing to do with this, and couldn't possibly have altered the outcome. From his defenders, he's instantaneously transformed from 11-dimensional chess Master to impotent, victimized bystander. The supreme goal is to shield him from all blame. What gets said to accomplish that goal can -- and does -- radically change from day to day."

* Someone in a position of authority must know the Democrats' bottom line on health care. So what is it? All or nothing – or something in between? At this point, pressure is building to take what's available and improve upon it later. In fact, none other than the Big Dog himself, Bill Clinton, has suggested exactly that tack.

"Our only responsible choice is the path of action. Does this bill read exactly how I would write it? No. Does it contain everything everyone wants? Of course not. But America can't afford to let the perfect be the enemy of the good."

Meanwhile the clock is ticking down. President Obama presides over two unpopular wars and an economy saddled by persistently high unemployment rates. The Democrats may very well lose their majority in Congress next year. And if the situation fails to improve markedly, the 2012 race for the White House will be tight. Kevin Drum at Mother Jones correctly notes that when major legislative efforts fail, they don't often return to the calendar soon after. "It didn't happen in 1936, it didn't happen in 1949, it didn't happen in 1974, and it didn't happen in 1995. What makes anyone think it will happen in 2010? If healthcare reform dies this year, it dies for a good long time."

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