The larger point is that the political trade-offs in the healthcare debate are as difficult for the Democrats as the policy trade-offs. Ultimately, they are unlikely to get meaningful support from the GOP (and I include Sen. Olympia Snowe in that statement). House Leftists threaten to kill a bill that does not include a strong government-run insurance plan, while their special-interest allies threaten moderate Democrats leaning against a big-government plan.
The political and policy tensions were always going to be there, as they were when the Clintons failed to take over the healthcare system. That is why Ezra Klein makes sense in theorizing that Obama’s strategy is to get a couple of bills — any bills — into a House-Senate conference, write the real bill there, and force it on moderate Democrats. The only flaw in that theory is the presumption that none of the moderates would filibuster. That’s why the Senate’s admitted Socialist, Bernie Sanders, is already working on the Democratic caucus to swear off a filibuster. It is a strategy that may yet underestimate Senators’ instincts for self-preservation, as voters and stakeholders will quickly figure out which votes matter as the debate unfolds. But given the competing political interests involved, it may be the most logical track for the Democrats to take.