Ross Douthat notes that two of Obama’s key constituencies—liberals and the media (in this case, there is a difference)—have had it with him. He explains:

As the health care debate enters its decisive weeks, the left doubts President Obama’s commitment, and the press doubts his competence. . . . Where the left sees betrayal, the press sees ham-fistedness. The White House’s messages have been mixed—fiscal hawkery one day, moralism the next. The administration has allowed distractions like the Skip Gates affair to crowd out his agenda. It has overlearned the lessons of the Clinton-care debacle and given Congress too much leeway. It has underlearned the lessons of the Bush-era Social Security debacle and gone to war before there’s an actual piece of legislation on the table.

He concludes that it will be a failure of strategy and deal-making if the Democrats blow their once-in-a-lifetime chance to pass government-run health care.

But like so many pundits arrayed along the political spectrum, Douthat sees this as a tactical failure. It is the process that went wrong. This seems badly off the mark. The fundamental problem with ObamaCare is ObamaCare itself and its assumption that the entire health-care system must be ripped out by the roots and reworked, with the government front and center. Obama—not Nancy Pelosi—wants a public option and stringent controls on “unnecessary” care (to be determined by new panels of technocrats). That’s isn’t a process failure; it’s one of substance.

The error made by Obama and his congressional allies was to assume that, in the midst of a recession, the public would be amenable to a huge dislocation in the health-care system, a new tax regime, an enhanced role for government and a diminished one for practitioners and private insurers. That was wrong. Most Americans have insurance and most like it. Most Americans don’t trust bestowing on the government broad new powers to control their medical care.

Pundits are often enamored with analysis that ignores the substance and focuses on Washington-insiderness and tactical decisions, which only they have the time and expertise to translate for nonprofessionals (i.e., real people). This is especially true with regard to health care. But in this case, they certainly miss the central issue: Americans don’t want government-run health care.

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