WASHINGTON -- Whatever the legislative fate of health reform -- now in the hands of a few besieged House Democrats -- the health reformers have failed in their argument. Their proposal has divided Democrats while uniting Republicans, returned American politics to well-worn ideological ruts, employed legislative tactics that smack of corruption, squandered the president's public standing, lowered public regard for Congress to French revolutionary levels, sucked the oxygen from other agenda items, re-engaged the abortion battle, produced freaks and prodigies of nature such as a Republican senator from Massachusetts, raised questions about the continued governability of America and caused the White House chief of staff to distance himself from the president's ambitions.
It is quite an accomplishment. For the president, it must also be quite a shock, because he thought he was taking a reasonable, middle path on health reform.
At the start of this process, many Democrats preferred a single-payer health system -- essentially, Medicare for everyone. Short of this goal, they advocated a public option that would compete with private insurance companies and prove the superiority of government-run care. But President Obama rejected a single-payer approach and signaled early that the public option was expendable.
Obama also rejected the one, genuinely bipartisan health reform proposal -- made by Sens. Ron Wyden, D-Ore., and Bob Bennett, R-Utah -- that would have ended employer-based insurance and given individuals a deduction to buy their own coverage from a menu of private insurance options. (Wyden has turned out to be the ignored prophet of the health debate. "If you ... just pound it through on a partisan vote," he said last June, "you have people practically as soon as the ink is dry looking to have it repealed.")
Instead, the president chose the current complex, regulatory approach to reform, precisely because it seemed less radical and disruptive than the other options. It was patterned in part on health reforms in Massachusetts signed by then-Gov. Mitt Romney, a Republican, thereby applying at least a veneer of bipartisanship.