Battered for weeks by an artfully choreographed resistance campaign, President Barack Obama returned from pushing his healthcare reform plan in western states last night, amid signs that he might be ready to seek compromise on key details of it with his foes.
But even as the first hints began to surface that the White House could consider dropping its insistence that a new healthcare system includes some kind of public entity offering insurance to consumers, the liberal wing of his party was rising up yesterday to denounce any such retreat.
"I don't think it can pass without the public option," Howard Dean, the former Democratic party chairman, warned on CBS TV. "You can't really do healthcare reform without it. There are too many people who understand, including the President himself, the public option is absolutely linked to reform."
Senator John Rockefeller of West Virginia reaffirmed his support for a public insurance body. "I believe the inclusion of a strong public plan option in health reform legislation is a must," he said.
However, it has been clear for months that in the Senate at least, any bill with the public option stands no chance of winning bi-partisan support and may very well drive away conservative Democrats, a result that could kill the effort entirely. "There are not the votes in the US Senate for the public option," Senator Kent Conrad, a Democrat, said at the weekend.
In this game of three-dimensional chess, divining the intentions of Mr Obama is tricky. It was Health Secretary Kathleen Sebelius who floated dropping the public option at the weekend. The White House may be willing to see how that balloon flies but might yet choose to harden its stance again. Or it could be the public option was a bargaining chip that was always going to be surrendered.
What is certain is that the administration still hasn't regained control of its reform message. The August recess has been dominated by images of members of Mr Obama's party being barracked at healthcare rallies by citizens apparently enraged by what they see as a "socialist" take-over of their healthcare choices.
Little of this is spontaneous. There is ample evidence that many of those at the town hall meetings are being encouraged to attend by conservative advocacy organisations such as Americans for Prosperity, Grassfire, Tea Party Patriots, and Resistnet, and even given tips on how to pressure legislators. FreedomWorks has reportedly posted 380,000 "August Recess Action Kits" to stoke the brouhaha.
Equally obvious has been the magnifying effect offered by the internet and the media. Video clips of voters yelling hysterically at lawmakers have become must-views for many conservatives on YouTube.
"The internet has profoundly affected campaigning, and certainly public-policy deliberations. It provides a way to circumvent the usual media for information delivery," said Terry Madonna, director of the Centre for Politics and Public Affairs at Pennsylvania's Franklin and Marshall College. Not that the media has been of much help to Mr Obama either, who noted on his latest swing through western states that "TV loves a ruckus", a reference to the volume of coverage given in recent weeks to the town hall confrontations.
Then there are the TV talking heads who unabashedly fan the flames of opposition to his plan like Glenn Beck on Fox, which is enjoying a ratings bonanza in the age of Obama. "Fox TV and talk radio are still the main drivers for the conservative movement," suggests Eric Boehlert of MediaMatters.org, a liberal advocacy site for journalism.
Less visible has been the heavy spending of those with most to lose from reform – the insurance industry and the pharmaceutical industries. While they may pay lip service to the notion of an overhaul, the insurance lobby in particular is spending millions – by some estimates a million dollars a day – to block the public insurance option in particular.Reuse content