Comprehensive health reform was popular with the electorate before the elections of 2008. Mr Obama won the presidency on a pledge to introduce it. Elements of the reform, tested one at a time, still poll well. The Republicans offer no plausible alternative. In many ways the Democratic reform is a long overdue advance, ending the scandal that the US, alone among advanced nations, fails to provide healthcare to all its citizens.
Yet the uncertain fate of this righteous venture is in large part the Democrats' own fault. Before passing the reform, they failed to explain it or defend it to the public, thinking this would take care of itself. That was a gamble, which they lost. Then, better late than never, as it became plain that the reform was failing to win the public's confidence, they should have campaigned for it - as the president repeatedly promised he would. Instead, they ran away.
Some of their losses next week will be due to these choices. Worse, Mr Obama's historic reform might yet be in jeopardy.
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