Mike Murphy isn't wrong here:
The Obama plan to date has been an over-sweetened cocktail of sugary promises and fudged math. The president has not explained where he really, ultimately stands on the big details. You can’t lead the country as a policy cipher, hoping to spring your specific views on the matter at the last minute, after months of ugly Congressional sausage grinding.
But he isn't entirely right, either. Look: the Congress has a role in the US system. In some ways, Obama is returning governance to its rightful balance. He is a community organizer remember? He's not The Decider. We had one of those for eight years and we don't need another.
The Clintons tried the specific views approach and that didn't help much. The truth is: this is a very, very hard political issue. We have to choose between a healthcare sector simply destroying the US economy on current trends, and being prepared to get our healthcare rationed, cost-tested and less technologically sophisticated. The downside is obvious; the upside is hidden. At some point in the last few years, it seems to me, the balance shifted against sustaining the status quo, if we really want to provide near-universal care and don't want to bankrupt us even further.
I think Obama will get something real, modest and very weak when it comes to cost-cutting. The American political system simply does not have the capacity to deliver anything more. It will when we have no choice. We're very close to that. But disaster is necessary for this country to do anything that might actually work.