Commentary: On health care, the middle is a dangerous place to meet

WASHINGTON a€" It is a core belief of Washingtona€™s political culture that policymaking by compromise a€" a€œmeeting in the middlea€ a€" is the way to gain and keep the support of the vast, moderate, essentially reasonable group of voters who constitute a coherent political center.

My problem with this analysis is that so many of the big decisions that have to be made are binary: yes or no. The only terrain in the middle consists of a€œmaybea€ or a€œkind of,a€ and I see no evidence that the country is in a a€œmaybea€ or a€œkind ofa€ mood.

Much of the energy, passion and anger on display at the health care town-hall meetings was irrational and based on ridiculous misinformation. But the emotion was real, and it reflects the fact that the far right is essentially taking an obdurate, rejectionist stance toward anything President Obama tries to do.

Republicans in Congress clearly have decided that it is in their interest to keep these motivated activists within the fold a€" even the crazy a€œbirthersa€ who deny Obamaa€™s legitimacy as president and the militant yahoos who question his patriotism. If ever there was a chance to win Republican support for legislation providing meaningful health care reform, that moment has passed.

This makes health care essentially an intramural fight among Democrats. The partya€™s activist left isna€™t as raucously gonzo as its Republican analogue. But it would be a mistake for the president or the Democratic leadership in Congress to underestimate the passion for health care reform among their partya€™s activist base.

Democrats have dreamed of universal health care since the Truman administration. Obama campaigned on a promise to deliver it, or something very close. In retrospect, it was probably a mistake for Obama to allow the public option to become such a litmus test. A government-run program is not a prerequisite for universal health care, as nations such as Germany, France and Japan have demonstrated. But the only reasonable trade-off for dropping the public option, in my view, would be the ability to move health-insurance coverage much closer to true universality. Instead, the Senate a€œGang of Sixa€ negotiators a€" those trying to somehow a€œmeet in the middlea€ a€" seem to be moving in the opposite direction.

Democrats are right to believe that they have to pass some kind of health care bill or be accused a€" justly, Ia€™d say a€" of stunning incompetence. But whata€™s the point of making concessions to Republicans who, in the end, arena€™t going to vote for the legislation anyway?

In the end, Democrats will probably reason that something is better than nothing and pass some kind of bill that can be labeled a€œreform.a€ But if ita€™s seen as watered-down, Obama may pay a price.

a€¢Â Contact Eugene Robinson at eugen

erobinson@washpost.com.

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