Mark Blumenthal takes a stab at why Americans are more pessimistic about health insurance reform:
The most important thing to remember is that Americans most likely to be shifting their opinions are those least engaged in news about the ongoing Congressional health care debate. And even though most of the Pew Research News Index surveys in recent months show large majorities who say they are "closely" following the debate, they also find that nearly half of adults (44%) do not know that the "public option" deals with health care, while four-out-of-five cannot pick Max Baucus' name from a list of four senators as the chair of the Senate Finance committee working on health care.
He cites more negative ads from reform opponents, process coverage, and Democratic disunity as contributing factors. I'd add the sheer, mind-numbing, nerve-stretching, politician-watching endlessness of it all. If I were not paid to follow these ins and outs, I'd find the whole process alienating.
But this ghastly process is what legislating such an enormously complex bill actually requires. And I do think that one of the most under-estimated aspects of the Obama presidency has been his insistence on letting legislators ... legislate.
This is their job. Maybe it's because that's where Obama came from; and maybe it's because he understands that the Clinton approach failed. But it is also a conservative re-balancing of constitutional order.