The real story is Barack Obama. This is Obama's bill. And the failures of the bill, however you grade it out, belong to him.
Okay, here we go. The reason that neither the public option nor Medicare expansion is a part of the Senate's health reform bill are that there were never 60 votes in support of them. Obama could publicly orate or privately cajole the pivotal senators until he was blue in the face and there still wouldn't be 60 votes for those provisions. He simply does not hold leverage over them.
He never publicly went after Lieberman. Or Nelson. Or Lincoln.No, he didn't, and with good reason. Lieberman is not part of the president's party and actually campaigned against Obama's presidential bid last year. Sens. Nelson and Lincoln are from states where Obama and his agenda are deeply unpopular. Exactly how would the president's energies translate into votes here? What good would it do to threaten these senators? With what could he threaten them even if he wanted to?
Obama never threatened to take on the filibuster rule with reconciliation.
Of course Obama never threatened reconciliation; he's not a member of the Senate. And there's plenty of evidence that a majority in the Senate -- including quite a few Democrats -- would oppose this approach anyway.
Obviously, there will always be temptations to Tuesday morning quarterback the president on his negotiations with Congress. But critics need to think seriously about what, if anything, the president could have done that would have actually changed the votes of Sens. Lieberman, Nelson, or Lincoln.
If liberals are upset by the the concessions made to pass health reform in the Senate, they should direct their fire at the filibuster. This tool of the minority was once a rarity but is now threatened on almost every important piece of legislation the Senate considers, to the point that you now need 60 out of 100 votes to pass or even begin debate on anything. This means that even though the Democrats hold the majority in the chamber, no bill will pass that doesn't meet the wishes of the 60th most liberal member of the Senate, who is usually relatively conservative.