In the friendly confines of the Oval Office, congratulations are about to be exchanged. On those dithering heights, victory is about to be proclaimed. A great change is about to take place in Americans' health care and how to pay for it, and the administration sounds triumphant.

It is only out here in the country, where the people are, that a growing disquiet can be sensed under the usual thrust and parry of American politics.

The country is about to pass "a critical milestone," the president assures us, though whether America is headed forward or backward remains unclear. Not to mention how American the country will remain as everything from the economy to foreign policy is Europeanized.

Despite growing doubts about where the country is headed, surely the direction is the right one. We know because Nancy Pelosi says so. But even to mention her name is to sow doubt; the speaker of the House may be the least trusted politician in the country, not counting household epithets like Barney Frank, Chris Dodd, Harry Reid and, well, name your own unfavorite member of that all-too-familiar crew.

"We are about to deliver on the promise of making affordable, quality health care available for all Americans," says Speaker Pelosi, who always speaks in talking points, joining Tinkertoy phrases till they add up to a press release.

Do you believe her? Do you believe setting up a public health insurance plan won't entrench what is already becoming a two-tier system of medical care in this country -- one for those patients with private insurance and the other for the growing millions with Medicaid-style policies?

Do you believe that expanding Medicaid, cutting Medicare, and generally extending health coverage to some 36 million of the now uninsured, will make insurance more affordable? And, what's more, that it will all be done without raising taxes? Can even Nancy Pelosi believe that?

The dithering in the Oval Office has only begun. But for our troops in Afghanistan, it's been going on for years. This president and commander-in-chief was once so sure that this war -- his war -- had to be won. But that was before he had to command. Now he dithers. Still another comprehensive review of strategy is under way. While the fighting and dying goes on, and the generals, like their troops, wait to see what American policy will be, if any.

Opinion at the top seems divided between the not-so-commanding general and that military mastermind, Joe Biden. The general, Stanley McChrystal, has asked for more troops, recognizing the need to assure security in that ungovernable land if the Afghans, like the Iraqis, are finally going to take responsibility for their own defense. But the vice president, as usual, has opted for a policy that is as simple and easy as it is wrong: a Rumsfeldian war-on-the-cheap fought long-distance. Victory Through Drones! Never mind that his approach isn't succeeding; it sounds good politically, and isn't that what counts? Any problems, anywhere, can be blamed on George W. Bush. Continued...