A brilliant piece of analysis. I'm unsure about the full implications of the "not a dime" pledge (I hope David's right). But I am sure about the political strategy: get universal healthcare now, begin the process of cost-cutting, get insurance exchanges on the ground and running ... and do it all in as inclusive and moderate a way as possible. I think Obama will pull this off - not easy when a third of the country seems to have lapsed into total ideological hysteria. Our job then will be to hold his fiscal feet to the roaring fire.