Leave it to Mickey Kaus, a principled liberal who supports health care reform, to debunk these structural excuses: “Lots of intellectual effort now seems to be going into explaining Obama’s (possible/likely/impending) health care failure as the inevitable product of larger historic and constitutional forces. … But in this case there’s a simpler explanation: Barack Obama’s job was to sell a health care reform plan to American voters. He failed.”
He failed because the utter implausibility of its central promise — expanded coverage at lower cost — led voters to conclude that it would lead ultimately to more government, more taxes and more debt. More broadly, the Democrats failed because, thinking the economic emergency would give them the political mandate and legislative window, they tried to impose a left-wing agenda on a center-right country. The people said no, expressing themselves first in spontaneous demonstrations, then in public opinion polls, then in elections — Virginia, New Jersey and, most emphatically, Massachusetts.
That’s not a structural defect. That’s a textbook demonstration of popular will expressing itself — despite the special interests — through the existing structures. In other words, the system worked.