Senator Reid throws down for a partial public option;Is Washington hearing us now?

Monday evening a friend who works in medicine told me her story of calling Senator Harry Reid's office to insist that he put a comprehensive health care reform bill with a strong public option to a vote in the Senate.

I told them I lived in California. But I'd been to Nevada last year to help elect President Obama -- and I was willing to come back to help him, if he did the right thing.

She didn't report her implied threat -- if Reid didn't come through for real health care reform, he could forget support from grassroots California Democrats. But I'm sure his office gets that. And he is facing a difficult re-election.

As we move toward some endgame on health care reform, political calculus is beginning to nudge the policy wonks out of the way. They may know their economics and their "bending the cost curve." But ordinary citizens experience this debate at a visceral level: will I die because an insurance company is dicking around with me? Will my kid suffer for someone's profits?

Grassroots pressure is beginning to weigh in against the permanent pressure from the medical-insurance complex.

I don't usually put much stock in stories from Politico; the online publication runs too high a ratio of poorly-sourced Washington insider gossip to reporting for my taste. But today David Rogers offered some interesting insight into how the needs and desires of the Democratic base are beginning to light a fire under Congressional leaders and have put them on a slightly different track from the President.

Having bet the farm, President Barack Obama needs a win and is willing to settle for a cheaper bill and a weaker public insurance option. Democrats in Congress, increasingly worried about the 2010 elections, want stronger medicine for fear the reforms will prove to be a house of cards if working-class voters can’t afford the coverage promised.

That's a big, underappreciated reason why the public option has resurfaced in recent weeks in what’s really a proxy war for the affordability debate. ...

"The White House wants the accomplishment," said one Senate Democratic aide. "The speaker and Reid are worried about the base not turning out in 2010."

When the White House made deals with the drug companies, doctors and hospitals, it acted as if these were the only forces at play in the health care reform. And those deals probably did restrain the medical-insurance complex from getting straight in bed with the nutcase teabaggers.

But millions of people -- people who put the Democratic majority in office -- were left out of these calculations. Determined agitation has put activism by ordinary citizens into the political equation.

We aren't going to win what we really want (single payer and the insurance companies put out to pasture) but we just might get something that's an improvement on what our betters would deliver if left to make their deals in private. They have become more and more aware that if they deliver health care reform that makes only superficial changes and costs so much people can't use it, they will reap the wrath of many experienced shit-disturbers.

That's what our President gets for exciting hope for change. Don't imagine he much likes it -- none of us do when we're on the receiving end of popular pressure. But that's democracy. And this is the time to press harder, not to take Reid's decision as some kind of rest stop ...