The political risks of success for health care reform

...If this legislation passes, Democrats will be held accountable for any failures or problems in the system. So if Americans' insurance premiums rise, they will blame the Democrats. If patients have to wait in line at emergency rooms, it will be seen as the Democrats' fault. If health-care costs don't drop, the Democrats will face the wrath of the electorate.

Many Democrats, including people in the administration, blame poor marketing for their difficulties in passing health reform. They say they haven't gotten the message out. But advocates of reform have spent millions on advertising and lobbying this year. And Obama, who many say is the best orator ever to occupy the White House, has pushed for this legislation constantly over the past six months. In that time, support for Obama's handling of health-care reform has dropped by more than a net of 30 points.

Yet before Republicans cheer that they may defeat this effort, they should beware what they wish for. A vast majority of Americans still believes that we need fundamental health-care reform. If the legislation fails, Democrats can blame Republicans by saying reform was in sight and the GOP blocked it without offering a real alternative to decrease costs and increase access.

The dominant issues today are the economy and jobs, and the public doesn't see either party making these a real priority. Further, polls show trust in government handling of domestic issues remains at historic lows. What most voters hear from Washington these days is squabbling over health reform involving a government role they don't trust and don't want.

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