Michael Gerson

It was a miscalculation. Americans were neither as desperate nor as malleable as they were during the New Deal. Obama's massive spending, intended to stabilize the economy, also drained the Treasury, making it more difficult to propose major new expenditures. Deficits of $9 trillion over 10 years have raised the prospect, according to Warren Buffett, of an American "banana republic" -- endlessly printing money, weakened by inflation and abandoned by foreign bond investors.

At the same time, as William Galston of the Brookings Institution points out, public trust in government remains "close to all-time lows." "Even when President Obama's popularity was at an all-time high, in March and April, trust in government barely moved off the lows of the fall. Obama's personal popularity did not translate into a belief in the efficacy and integrity of government."

Add to this the fact that one of the main sources of revenue to fund Obamacare is reductions in Medicare. Many seniors are naturally concerned that proposed cost constraints in this program might eventually mean service constraints. And it doesn't help that cuts in Medicare would be used to fund someone else's entitlement, instead of strengthening Medicare itself.

Democratic partisans still insist that imposing reform by a "go-it-alone" strategy is possible and necessary. The political cost, the argument goes, has already been paid. Why not reap the political benefit by pleasing the base? Didn't we see, in 1993 and 1994, the cost of coming up empty on health reform? It can't happen again.

This might make sense if the main obstacle was Republican resistance to a popular bill. But it isn't. Democrats are fighting against a swift current of fiscal responsibility, widespread skepticism about government and resentment against the use of Medicare as the smashed piggy bank for reform.

A party-line, Democratic transformation of American health care in this environment -- in the midst of decisively losing a public argument -- would smack of power-hungry radicalism, more the liberalism of Robespierre than Jefferson.

Obama's choices on health care during the next few weeks will determine much about the nature and trajectory of his presidency. Eventually it comes down to a question: Will Obama make necessary strategic adjustments before his political humiliation -- or after it?

Michael Gerson

Michael Gerson writes a twice-weekly column for The Post on issues that include politics, global health, development, religion and foreign policy. Michael Gerson is the author of the book "Heroic Conservatism" and a contributor to Newsweek magazine.
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