But getting to the end -- getting a bill to the floor -- can't be explained with reference to the same metaphor. It's way more complex. Functionally, when a particular debate becomes public, the goal of getting legislation to the floor usually advances. These issues don't arise out of nowhere. They've been there, and issue entrepreneurship in Congress wait for the right moment to spring them.  The Blue Dog objections and "demands" are intermediary steps toward the end of getting a bill to the floor; they're proffers in negotiations. When House leaders do "x" and Senate leaders do "y," and it seems to shift the debate or change the legislative calendar, one should assume that these actions are taking place because they will speed passage given the current, always-changing realities of 535 members of Congress, dozens of powerful interest groups, millions of patients and doctors, and the White House.  The full political consequences of supporting or opposing legislation will only be intelligible when a single bill hits the floor for final passage.  

The timetables set by Congressional leaders were ambitious, and designed to kindle the sort of intense heat that has been generated. The  fact is that health care lawmaking is proceeding rapidly, maybe a bit too rapidly.  I don't know what the final bill will look like, or whether it will be "ideal" from the perspective of the majority. But nothing seems to indicate that the President won't get a bill that accomplishes many (though maybe not all) of his primary goals.