Click the fist link and the post will be comprehensible.
Pearlstein shifts back and forth from politics to policy to dodge counter arguments. He begins by discussing the political problem of vested interests and continues by discussing political strategy -- how could Obama have avoided the current difficulties and how can he get a bill passed "Obama gave up the moral and political high ground that would have made the opponents of reform look "small" by contrast".
By the end of the essay, he discusses "what the president needs from congress" and not how to get it. Basically he proposes that congress disempower itself. This is not realistic. Senators like the fact that each has enormous power. Legislators in general like the fact that special interests are begging for their support.
It is odd to start with a discussion of legislative strategy, then switch to pure fantasy.
Of course the reason is that the initial discussion presents pundits fallacy strategy -- Pearlstein thinks radical reform would be good and so he argues that it would be politically successful by making opponents seem small. He doesn't note that 41 senators who seem tiny plus a scared majority leader can block reform.
Seems to me that reform opponents seem to be totally dishonest and/or insane. I don't see how they could look any worse. So ?
To be specific Pearlstein accuses Obama of kowtowing "to organized labor by backing away from a reasonable cap on the favorable tax treatment of health benefits. When exactly did Obama do that ? He absolutely opposed taxing health benefits during the electoral campaign. Alternative sources of funding were proposed in the House tricommittee deal without detected White House input. I think Pearlstein wants to cap the favorable tax treatment of health benefits, assumes that Obama is responsible for everything that happens under the Sun and blames Obama for the fact that things aren't working out the way Pearlstein wants.
I think the preceding sentence proves my case "From a business community that wants to preserve the employer-based system, he failed to get a commitment that all employers should participate." Oh and he failed to make the Republican party a responsible opposition party and it was too damn hot in August.
Also, like many commentators , Pearlstein asserts that his priority (bending the cost curve) is so important that, without it, health care reform is worthless. Hence we get
the United States... the only rich country to ration medical care on the basis of income. [skip]
If reform doesn't "bend the cost curve," ... then it's not worth doing.
Literally this means "it is a fact that the US is the only rich country to ration medical care on the basis of income, but eliminating that aspect of the US health care system is not worth doing unless we get something else too." Does Pearlstein really not care at all about the uninsured ? Does he consider their problem to be trivial and not worth bothering with unless he can get what he wants ? Is there some other possible interpretation of "not worth doing" that I missed ? I think that "not worth doing" was just sloppy hyperbole -- a statement which Pearlstein absolutely doesn't believe and which should have been caught by an editor.
The views on political strategy expressed in the essay are fairly consistent -- volere potere (roughly where there's a will there's a way) that is, lets assume the problem away.
I think there is a better essay screaming to get out of this just rather good essay. It is a discussion of policy without the pretense that congress might reform itself out of power. The problem with that is that the time for such essays was years ago and they were written then (by Pearlstein among others I'm sure).