Obama is very bright, but he and his people are authors of their own misfortunes on health care.
1. Americans will normally resist a suggestion that wealth be directly transferred from haves to have-nots. If anything, they are even more resistant to cutting government benefits to people who now get them (especially Social Security and Medicare recipients, who are seniors) in order to do more for others. The boomers are getting old, and they will probably be even more defensive of their own government benefits than their parents were. One difference in the U.S. is that they will sometimes pretend, bizarrely, that Medicare is not an expensive and wasteful government program. The Obamaites proceeded as if they had no clue about these facts.
2. Americans who have health insurance are generally happy with it, despite the anxieties about cost or suddenly being told that you are not covered. Mickey Kaus has said all along that the Obamaites should have addressed these people directly and said: we will let you keep your benefits, and improve them, with more assurance that they will be there when you need them.
3. The Obamaites got caught up in the question whether a new program would be fiscally responsible, short term and long term. They committed themselves to "bending the curve" by bringing down long-term costs. This naturally raised anxiety about how exactly this would be done. Government bureaucrats second-guessing doctors and patients?
4. The other Emmanuel, and Obama himself, have both mused about a government agency making quality of life and quality of care decisions. Palin was not "making things up."
Why on earth did the Obamaites get themselves bogged down in #3 and #4? Noone was forcing them to do that. They seem to be determined to be McGovern and Mondale Democrats, as if they have learned nothing from the intervening years.
I would simply add: it is increasingly clear to me that Obama does not really believe there might be decent and intelligent people who disagree with him. He is reluctant to admit anybody at all disagrees with him--he tries to say they are focussed on whether a good idea will actually work, or something--but to the extent that he acknowledges their existence, he is quick to suggest they are deluded, mentally ill or worse. That remark of his during the campaign: "they cling to their guns, God, etc." really did express some of his thoughts. At best "they" suffer from false consciousness, no doubt deliberately cultivated by corrupt lobbyists and such. He has sown the wind by letting his contempt for a lot of people show, and how he is reaping the whirlwind with the nasty townhall meetings.
But the truth is, is that, our challenge is to get people persuaded that we can make progress when there’s not evidence of that in their daily lives. You go into some of these small towns in Pennsylvania, and like a lot of small towns in the Midwest, the jobs have been gone now for 25 years and nothing’s replaced them. And they fell through the Clinton administration, and the Bush administration, and each successive administration has said that somehow these communities are gonna regenerate and they have not. So it’s not surprising then that they get bitter, they cling to guns or religion or antipathy to people who aren’t like them or anti-immigrant sentiment or anti-trade sentiment as a way to explain their frustrations.
I think it is the hallmark of an educated person to understand that decent and intelligent people can have deep disagreements. Maybe Obama is a true consensus-builder in that he thinks all the "extremists," who have difficulty compromising, are the same--all a bit crazy, mistaking a partial truth for absolute truth. His friends on the left are already a bit shocked at his willingness to abandon their favourite causes. Still, he's probably hoping to carry out substantial parts of a left-wing agenda, if only the capitalists and bigots will let him.
Reagan and the two Bushes may have thought there was something wrong with their opponents--they were certainly suspected of hating their opponents--but they gave remarkably little sign of that. Cheney has come close to saying that anyone who disagrees with him is a traitor or a fellow-traveller. I don't think Bush Junior has ever suggested that.