It is difficult to believe that only 16 years ago some of us were outraged by the Harry and Louise ads. Those ads seem quaint compared to what we are seeing today from the opponents of health care reform and their scare tactics that are just short of saying that health care reform means President Obama will personally sign orders to kill anybody who is sick or over 60 years old. It is, however, a good bet that if we wait long enough, we will start hearing that as well.

This is unfortunate because health care reform is long overdue. A more efficient system that insures more people, simplifies the health care process, brings costs down and creates rational incentives for health care providers, health care seekers and everybody else would be of great value to the entire country. The creation of such a system would be very difficult, and perhaps not fully possible, but it should be the goal of Obama's policy.

The political reality is that given the margin with which he was elected and the substantial margins by which the Democrats control both houses of congress it is likely that we will get some form of an Obama health care bill. It is, unfortunately, increasingly clear now that the bill will be limited in scope. Moreover, any chance of a serious debate about how to balance competing needs and political realities has been shouted down. Because the anti-health care reform interests, in collaboration with broader right wing organizations, have invested in scare tactics, rumor mongering and fear to the preclusion of negotiation, communication or compromise, the Democratic health care bill will probably not be as inclusive as many of us would like; and a major progressive goal of more than half a century will still be unmet.

The failure of health care reform will not in itself be a devastating blow to the progressive movement. After all, we have failed, or been stopped, on this issue many times before. However, if health care reform fails it will raise serious questions about a central premise of both Obama's campaign and the progressive movement that supported it. The debate about health care, is part of the broader movement and thus is also a debate about how we do governance, pitting those who believe we can change and move away from the nastiness and partisanship of the last twenty years against those who believe that the problem with how we have done politics in the last 16 years is that we were too calm. At its base, this is a fight over whether change is possible. Accordingly, the defeat of meaningful health care reform may well signify the defeat of the optimism and hope surrounding Obama as well as of the notion that it is possible to make real change in Washington.

The promise of change in both the substance and style of politics was deeply felt when Obama took office. So far, the Obama administration has given us some important pieces of legislation passed, a refreshing movement away from the radically ideologically driven Bush administration and a far more style and intellect in the White House, but the promised dramatic change is still very much a work in progress. The economy may recover, but it is clear now that it will not fundamentally change. We will likely get a health care reform bill, but there is a real possibility that it will be one of essentially half measures.

The health care debate so far has clearly shown that Obama has brought change to Washington. Before Obama was president, major media figures did not compare the president's administration to Nazi's, opponents of the president's policies and once and perhaps future leaders of major political parties did not suggest that the president was going to establish death panels, and elected officials of the party out of power sought to calm, not stoke, the noisiest and most radical opponents of the president. These changes are not the fault of the president, but speak to the extent to which the president's opponents will go, and their willingness to use increasingly outrageous tactics, to oppose the president. Seven months into the Obama presidency the Republicans' biggest, and perhaps only, success has been drowning the optimism from earlier in the year in a pool of red baiting, misinformation, comparisons to Nazis and intimidation. Defeating Obama on health care will be a big step towards making this Republican success permanent.

Lincoln Mitchell