Democrats either will or won't find their lost spines. Millions of people will or won't get access to doctors and the treatments they need. Thousands will or won't die annually for lack of medical access. And insurers will continue to profit, whichever way this turns out.
But even at this stage, there are beginning to be readily discernible lessons from the fight.
- Republicans really do have a policy agenda for most of us: "hand over your money and your life to the rich and then go die." Nothing more complex is to be found in that quarter, though they will always have intellectual whores who work to dress up this posture as some kind of principle.
- Democrats cannot be trusted to carry on a policy fight. In particular, the Obama administration bargains with itself and calls that "bipartisanship". Instead of asking the desirable and working down to the acceptable, it states its bottom line up front and let's that be chipped away.
- The only exception to this conduct in the health care process has been over the "public option." The administration seems to have included this money-saving, popularity-enhancing provision in the mix as a sop to its base, confident that it could back away from it as a demonstration of what mature adults they really are, despite being Democrats. The truth hasn't come out yet, but I am willing to bet that the White House promised insurance companies that if they'd mute their opposition to reform, they guarantee the thing died. Apparently Obama and Co. had no idea that their own people wouldn't go quietly.
- The health care reform struggle has been the arena in which progressives have retooled. We needed to. The netroots and on-the-ground capacity that progressives had built since 2000 was constructed entirely as a desperate defense against the worst of what Republicans were doing to the country. We've got to find a way for organized people to make themselves felt in new circumstances. This didn't look possible in 2002-3; it actually looks a little more possible today. As Chris Hayes put it in the Nation:
We're getting there. Just because we don't know right now everything about how to carry on the struggles we'll need to have for a more equal and humane society with our guy as the new impediment in the White House, that doesn't mean we can't learn.
No, electing Obama didn't mean we can rest. There's a great discussion in this archived Bill Moyers Journal that I recommend highly on that topic.