04/22/2010 05:12 am ET Updated May 25, 2011

The Psychology of Winning

I am a big fan of basketball, and I've always been fascinated by the way a game can be going all one direction, and all of a sudden, something happens and the momentum starts to shift. Players and teams who were nailing every shot are suddenly missing every one of them, the loose balls one team was getting all start going to the other side. Everything changes. It's all in the collective psychologies of the teams.

The legislative process often shifts just like a basketball game. The facts of the legislation may be the same, the official positions of the legislators may be the same, the debates about substance may be the same, the polling on the issue may be the same, but something happens to shift the psychology, and everything changes. That is where we are with health care reform right now.

After the Scott Brown victory, we had a few days of unmitigated panic, where Democrats were suddenly convinced that no matter how close they were to the finish line, all was lost and they had to leave the field in desperate retreat on the health care issue. Thankfully, that herd instinct subsided, and Democrats started realizing how feckless they would look for spending a year on the issue, coming this far, and not getting anything done.

Now we have a different problem: everyone wants to pass health care, but the process for getting there is procedurally complicated and politically difficult. The Senate doesn't want to go first, but the House simply can't: unless the Senate makes the adjustments they need to make, there is just no way to get 218 votes in the House. None. Nancy Pelosi is a remarkable Speaker in my my view, the most effective since Tip O'Neill, but not even she could get 218 votes for an unfixed Senate bill. The benefits tax is highly unpopular with House members, the infamous Ben Nelson special deal makes a bunch more walk away, Blue Dogs are nervous because of the political numbers, progressives don't like the low subsidies to the poor and middle class or the the fact that there is no public option. Pelosi probably couldn't get 180 votes for an unfixed Senate bill, let alone 218. The Senate may not want to go first, but it has to, there is no other option. And the White House needs to show more leadership on this and help lead them to that conclusion.

Speaking of psychology, the ultimate case study is the public option fight. Before Joe Lieberman blew up the deal, there were definitely 51 votes for a public option. Once he threw his tantrum and killed it in the old 60-vote Democratic Senate, though, a lot of Democratic Senators were secretly relieved: they didn't want to have to choose between making insurance company lobbyists and PACs mad and voting against a popular provision that their base loved passionately. After Brown won and the reconciliation discussion re-started, most Senators didn't want to go back to the issue because the fight over it had been so divisive, and Senators didn't want to have to make that tough choice. People hoped the issue would just quietly go away, and even a lot of the DC groups who had been working on it - all of whom had other big priorities in the health care fight, and all of whom were just desperate to pass a bill - were convinced to give up on the public option.

Grassroots progressives refused to give up, though. They refused to go quietly into the night, refused to accept the psychology of defeat, and they kept fighting. They got a letter endorsing the public option going that House members signed, more and more until the number shot past 100. Then they got a few Senators to take up the cause, and more of them signed up, too - the numbers have now hit 19 signatures. And then, Chuck Schumer, a member of the Democratic leadership, signed on. Then the White House said they would support it if Harry Reid said yes. Then Harry Reid said yes. And suddenly, the psychology has changed. A few days ago, everyone in DC thought the public option was dead for sure. Now, it's back on the table. Hard not to think of that old cliché that gym coaches pound into you when you're young: quitters never win, and winners never quit. Grassroots progressives never quit, and they deserve a lot of credit.

So health care reform lives, and the public option does too. But let's be clear: just as the pessimism about both was not right, neither should wild optimism be the feeling of the moment. We still have big, big hurdles yet to go before we get either the public option, or health care reform in general, passed. Procedural hurdles, political hurdles, psychological hurdles aplenty. Even with a Senate fix, getting to 218 in the House will be an extraordinary challenge, the biggest of Pelosi's career. And Harry Reid, who in my view has been very unfairly maligned in all this, still has a huge job getting 51 votes for the public option and for health care reform in general: he has a lot of Senators who really don't want to revisit the whole issue, and definitely don't want to have to make a vote on the public option. To Reid's credit, he has been working his butt off to get this done, but there are still about 15 Democratic Senators who are standing in the way.

Here's the final part of the health care psychology: everyone is sick of this issue. It needs to get done. The President and his White House need to be focused and tough in pushing this to conclusion. This is why we elect a president: to lead in the tough moments. And if health care reform -- with a public option -- gets passed, the psychology of this whole election changes again. Voters would see that the Democrats can persevere and get things done, and a discouraged base would get a huge energy boost. It is time for Democrats to dig in and win the game.