While the media has been filled with images of raucous town hall meetings and "tea party" protests from right wingers, these are largely irrelevant sideshows. The real pitched battle is within the Democratic party -- a battle that could determine the future of the Democrats as the governing party. In fact, the town hall circuses and the extremist rantings of right-wing talk radio have been a blessing in disguise for the Democrats, distracting the public from the growing intraparty schism in the halls of Congress.
But as the weather cools and the hard work of passing a health care bill begins this fall, the attention of the media and the public will turn away from right-wing ranters and directly onto the Democrats in Congress. Since virtually no Republicans will vote for health care legislation that is DOA in their districts, the question is whether enough Democrats in the House and Senate will vote to pass health care reform.
While the Blue Dog Democrats -- those who are most likely to lose their seats by voting for an unpopular health care bill -- are the first bloc of Democrats who have to be won over by the White House and the Democratic leaders, the liberal members of the House also have to be convinced to vote for whatever diluted version of health care reform emerges in the next few weeks. Although the House members from liberal districts don't have to worry about their jobs, they certainly have to be prepared to face the wrath of progressive voters who don't want to see the public option compromised.
On the most basic level, this gets down to old-fashioned political vote counting. Democratic members of Congress who face losing their jobs or displeasing most of the voters in their districts will think very carefully about voting for health care reform, even if it means a defeat for the President and their own party. However, if the Democrats in Congress fail to pass health care reform, they will be dealing both President Obama and, perhaps even more so, the Democratic party, a terrible blow.
Ironically, the President is in a better position to survive a defeat of health care reform than many Democrats in Congress. Unlike House Democrats, Obama has three years before he has to face the voters again. And he can certainly, and with justification, blame his own party for sending reform down in flames. While the President will of course aim to salvage health care reform, it will ultimately be up to the House Democrats to decide the fate of the bill.
If the Democratic party becomes irrevocably divided over health care reform, it will seriously threaten their majority in Congress, and call into question their ability to govern. Although it is unlikely that the public will embrace the Republican party, which is held captive by the extreme right wing, voters could well return to traditional voting patterns in 2010, particularly in swing districts, where they could throw out many freshman Blue Dogs, who account for the current strong House majority.
Since President Obama has arguably less to lose in this battle -- he could suffer a severe but not fatal setback -- it is the Democratic party itself, specifically the leadership in Congress, that needs to take a pivotal role in passing health care reform. Leaders of the liberal wing of the party -- not necessarily the elected leadership of the House -- must use their powers of persuasion and their skills in compromise to sway the debate in favor of change, most critically with progressive voters.
This is a moment of great opportunity to change the direction of health care policy in the United States. No solution will be perfect. Change will not come overnight. Some may deride this as "incremental change" when more fundamental reform is required. But even incremental change can be an important, positive beginning not only in improving our health care system, but in restoring responsible, responsive leadership to the governance of our nation.