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Could it be true?  Really?  Can we dare hope that this issue will be finally decided?

One year after (100 years, actually, if you're counting from the time Teddy Roosevelt launched his campaign for national health insurance) negotiations started on comprehensive health care reform - we're still talking about it.

But something has changed in the last few weeks.

President Barack Obama has energized his Party mostly through fear - if you don't pass health care reform you'll go down in flames in November's mid-term elections, he has essentially told them.

Obama has also campaigned across the country, finding his 2008 fiery voice once again and rallying support among grass roots Democrats who had been demoralized by the last few months of looming failure.

And it seems to be working - there is a very real chance that this bill will finally pass without a single Republican vote.

Critical to this change in fortune for the health care reform proclaimed dead some time ago, has been the insurance companies themselves, historic and implacable foes of reform. 

In an act of hubris or shear stupidity, some insurance companies, like giant insurer Anthem, significantly raised rates on policies a few weeks ago - thereby demonstrating the ongoing risk to national solvency of runaway health care costs and an insurance industry unable to ever act for the common good or even their true self-interest (lesson here: if you're about to torpedo health care reform again, don't flaunt it by raising rates).

Also important, the White House changed the framing of the issue. 

Where as the raison d'être of reform had been to cover the uninsured - making anybody with even bad insurance fear change and the unknown - they are now selling the benefits of the reform to the majority of the electorate who already has insurance but is reasonably anxious about the future should they change jobs, get seriously ill or simply if their employer drops coverage because of un-affordable costs.

The change in frame, the insurance companies collective hara-kiri, plus a realpolitik approach from the White House have transformed what could (still be if it does not pass) failure into potential victory.

The next few days and weeks will be decisive both for health care and the fate of the Democrats and the President's ability to implement the rest of his agenda.

Here's the President at one his rallies:

From the White House transcript of the President's speech:

There’s no government takeover, unless you consider reining in insurance companies a government takeover -- and I think that’s the right thing to do.  There’s no cutting of Medicare benefits.  There’s just cutting out fraud and waste in Medicare to make it stronger.  What we’re proposing is a common-sense approach to protecting you from insurance company abuses and saving you money.  That’s the proposal, and it is paid for.  And I believe that Congress owes the American people a final up or down vote on health care reform.  The time for talk is over; it’s time to vote.

ABC News reports on the Democrats' determination to pass the bill:

The AP reports:

House Democratic leaders on Thursday worked to rally their rank-and-file members around last-minute agreements on insurance taxes and prescription drug coverage that could move President Barack Obama's overhaul of the nation's health care system a step closer to reality.

Although some issues remained unresolved — including a divisive battle over restricting taxpayer funding of abortion — House Speaker Nancy Pelosi, D-Calif., said: "We have enough to move forward."

She asked Democrats at a two-hour, closed-door briefing whether they wanted to vote sooner rather than later on the legislation. They responded with a broad shout of "Yes!" according to lawmakers coming out of the session.

White House officials and congressional Democratic leaders met Wednesday evening in Pelosi's office. Aides said they agreed on scaling back a health insurance tax that unions object to, and on gradually closing the Medicare prescription drug coverage gap. They were not far apart on other major issues, including Medicaid funding for states that already provide above-average benefits, and on improving subsidies that would be available under the plan to help individuals and families pay their premiums.

Nancy Pelosi said last night on Charlie Rose that she has the votes to pass the bill:

Is it November already?

Sure seems that way judging by the fevered, election-like pitch of the health care reform debate.

After a painful (pre-existing condition alert) year of bitter back and forth between both parties, Democrats have decided to push forward with a simple majority vote to approve their health care reform bill.

Republicans have tried everything but kidnapping Nancy Pelosi to stop the bill - and are now faced with the same approval process for health care that they've themselves employed to approve the Bush Tax Cuts, Welfare Reform and parts of the "Contract with America", among other Republican bills.

Ironically, if the Democrats pass the legislation (as is now generally assumed that they will do), Republicans will either have a tremendous defeat handed to them or a powerful weapon for the mid-term elections.

Democrats as well will be in a position to show that they can get Washington to work or, if the Republican narrative is successfully framed in the media and voters' minds, a huge vulnerability that the GOP will wield like a club as they head into this electoral cycle.

What's clear is that this mother of all battles, a fight to determine the fate of one of the signature issues of the Obama Presidency, will play out over the coming weeks - setting the stage for either a Republican takeover of Congress or Democratic dominance that could last a generation.

For President Barack Obama, the success of this final push will condition his ability to move forward with his lengthy agenda of reform and either position him for a 2012 re-election or fatally weaken him into premature lame duck status.

For the American people, the final outcome of this battle will answer the question of whether or not our government can address some of the looming, transcendent issues that threaten our long term prosperity and super power standing.

So all eyes on Washington as Obama and the Republicans battle it out for the future of the country.

Republican Congressman Congressman Parker Griffith, who recently switched from the Democratic Party, makes the case for why the health care reform bill "must be stopped":

But Griffith may not be exactly the best messenger for the Republicans' opposition to Obama.  CNN reports that his party switching has engendered an interesting reaction in his home district in Alabama:

Former Democratic Rep. Parker Griffith rocked the political world in December when he switched parties and announced he would seek re-election as a Republican.

And now, only a few months later, his decision has prompted an unlikely coalition to form that is opposed to his re-election.

Democrats, Republicans and politically likeminded groups aligned with both political parties announced they will protest a fundraiser scheduled for March 8, in Huntsville. The headliner: House Minority Leader John Boehner.

Huntsville Tea Party, Left In Alabama, Athens-Limestone Tea Party Patriots, AAMU Democrats Student Club, The Dale Jackson Show, North Alabama Healthcare for All, Madison County Republican Executive Committee, and the Limestone County Republican Executive Committee issued a joint statement Friday announcing their intent to protest.

The involved parties share a goal, but have vastly different motivations. The Huntsville Tea Party said they will use the event to send GOP leaders the message that Griffith isn't their first choice.

"We are sending a message to the national Republican establishment: stay out of our primary," said Christie Carden, founder of the Huntsville Tea Party. "We also want to support the true conservative candidates that Tea Party activists and the local GOP have gotten behind ... We're pushing back against the political machine."

On the other side of the aisle, the AAMU Democrats Student Club took a swing at Griffith for abandoning the Democratic Party.

While Republicans vow to make the health care bill the centerpiece of the 2010 mid-term elections, the AP reports that Democratic chairman Tim Kaine is not worried:

Democratic Party chairman Tim Kaine said Wednesday he expects the health care overhaul will be passed and he's not worried about Republican threats to make it a premier issue in this year's midterm elections.

In a nationally broadcast interview, the former Virginia governor said, "If they want to run a campaign of bring back the day of kicking people off because of pre-existing conditions, I relish it."

Senate Minority Leader Mitch McConnell, R-Ky., had declared Tuesday that Democrats will enact the medical system reset at their own political peril, vowing to make it an issue in every congressional race this fall.

Here's Kaine on the potential impact to the Democrats in the election:

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Republican objections aside, Nancy Pelosi says "we will pass the bill":

The Washington Post reports:

Obama has called on Congress to vote on the long-debated plan in the coming weeks. His Press Secretary Gibbs said he thinks the House is on track to approve the Senate-passed health bill by March 18, though action on a "reconciliation" bill to make adjustments to the Senate-approved bill could take longer.

Republicans accuse Obama of attempting to "ram through" a bill that the public opposes. In the Republican's weekly address, Rep. Parker Griffith (R-Ala.), a physician who switched parties in December, renewed the GOP demand for Obama to move incrementally.

"Republicans understand that the right way to fix health care is with a step-by-step approach focused on lowering costs," he said.

In his remarks, Obama criticized Republicans for demanding that he scrap the effort and start over.

"The insurance companies aren't starting over," he said. "I just met with some of them on Thursday and they couldn't give me a straight answer as to why they keep arbitrarily and massively raising premiums - by as much as 60 percent in states like Illinois. If we do not act, they will continue to do this."

Obama said that the changes would also require health plans to offer free preventive care to their customers, while ending limits on the amount of care people receive.

"If we act now, all of this will happen this year," Obama said. "Millions of lives will improve. Some will be saved. Many families and small business owners will have health insurance for the very first time in their lives. Doctors and patients will have more control over their health care decisions, and insurance company bureaucrats will have less. This future is within our grasp."

In his weekly address, the President  pushes for a "final" majority vote for the bill:

From the White House's web site, a list of benefits of the President's health care reform bill:

Here are a few more points about how health insurance reform measures will benefit Americans this year:
 
Hold Insurance Companies Accountable:

• Eliminate lifetime limits and restrictive annual limits on benefits in all new plans;
• Prohibit rescissions of health insurance policies in all individual plans;
• Prohibit pre-existing condition exclusions for children in all new plans;
• Require premium rebates to enrollees from insurers with high administrative expenditures and require public disclosure of the percent of premiums applied to overhead costs;
• Establish a process for the annual review of unreasonable increases in premiums, requiring State insurance commissioners to work with the HHS Secretary and States.

Protect Consumers:

• Provide grants to States to support health insurance consumer assistance and ombudsman programs to help consumers;
• Ensure consumers have access to an effective internal and external appeals process to appeal new insurance plan decisions;
• Require all insurance plans to use uniform coverage documents so consumers can make easy comparisons when shopping for health insurance;
• Establish an internet portal to assist Americans in identifying coverage options;
• Prohibit insurers from discriminating in favor of highly compensated employees by charging them lower premiums.

Ensure Affordable Choices and Quality Care:

• Provide immediate access to insurance for uninsured Americans who are uninsured because of a pre-existing condition through a temporary high-risk pool;
• Create a temporary re-insurance program for early retirees;
• Require new plans to cover an enrollee’s dependent children until age 26;
• Require new plans to cover preventive services and immunizations without cost-sharing;
• Offer tax credits to small businesses to purchase coverage;

Facilitate administrative simplification to lower health system costs.

One year of painful negotiations, a looming mid-term election that is looking dicey at best, and no health care reform success is a recipe for political disaster that could torpedo his Presidency.

Unless you change the objective conditions of the battle.

And that is exactly what President Barack Obama has done by pushing Democrats to pass health care reform with a simple majority - the same technique utilized by Republicans to pass the Bush tax cuts, among other legislation core to their program.

The time for negotiations with a Republican minority committed to killing reform is over. 

Clearly, the GOP electoral strategy has been to stop reform - and demonize Obama's program as some sort of socialist take over. 

It's impossible to negotiate with an opponent who is trying destroy you.  And in this case, one year of negotiations with Republican moderates yielded nothing.

So Obama is moving the process forward  and calling for the Congressional Democrats to get beyond their own intra-party squabbles and vote.

Democrats have been, in many ways, as obstructive to the passage of reform as the Republicans. 

The not-seeing-the-forest-for-the-trees of certain narrow constituencies within the Democratic party has made a mockery of their huge majorities in Congress. It is not a surprise that Congress is held in very low esteem by most Americans.

Wobbly Democrats are in danger of self-actualizing their own defeat unless they take the not so bold action of finishing the reform package that they already approved in both Houses of Congress.

Here's the President yesterday at the White House calling for an "up or down vote" of the reform package:

Politco reports in the White House strategy:

Kicking off what he promised would be an aggressive campaign, Obama called on Congress to schedule a vote, saying the time for talking is done. And without saying the word "reconciliation," Obama made it clear that he¹ll pass legislation with only Democratic votes if necessary.

The president laid down a timetable that would wrap up the bill before the Easter break in Congress as well as a Democratic line of attack: We’re not passing health care in a backroom deal because it has already passed in both the House and the Senate under the traditional rules. All that’s left now is the cleanup.

“The American people want to know if it’s still possible for Washington to look out for their interests and their future,” Obama said. “I don¹t know how this plays politically, but I know it’s right. And so I ask Congress to finish its work, and I look forward to signing this reform into law.”

CNBC reports on the likelihood of success for the Obama strategy:

The New York Times reports on the Republicans' reaction:

“They’re making a vigorous effort to try to jam this down the throats of the American people, who don’t want it,” the Senate Republican leader, Mitch McConnell of Kentucky, told reporters after Mr. Obama’s remarks. “We think that’s a policy mistake, and we think resorting to these kind of tactics, to thumb your noses at the American people, is something that ought to be resisted.”