Does Passing Health Care or Not Passing Health Care Create More Democratic Headaches?

Quite a bit of reaction to Thursday’s piece, speculating that to Democrats, enacting health-care reform the way they prefer – creating a public option, with mandates, aiming for universal care – might be worth losing one or both houses of Congress.
Some folks wonder if I’m trying to discourage ObamaCare opponents, and that’s not my aim. It is, however, a recognition that the grassroots activists, who feel so passionate about this issue, could do almost everything right and still end up watching the bill get passed. Ultimately, the decision to pass or not to pass is in the hands of the Democrats.
Quite a few liberals – including Ana Marie Cox in our interview this morning – have a hard time seeing many Democrats being willing to sacrifice their careers to enact their vision. But obviously, you don’t need all of them; you need a coalition of Democrats in safe seats even in a Republican tsunami-year, coupled with enough willing to risk their seats over it. In the House, getting 218 out of 256 Democrats doesn’t seem that unthinkable. And most lefties agree that not passing a bill, or passing down a watered-down half-measure, would trigger furious reprisals and finger-pointing.

One other wrinkle – many of the components in the various bills don’t really kick in until 2013. So Americans who are backing these proposals, thinking they’ll get good health care at little cost, may find themselves disappointed to learn that they’ll be dealing with something similar to the same old system they hate, with the full changes enacted after the next presidential election. Presuming a bill passes, how many voters will feel health care has been “fixed’ in November 2010?

UPDATE: But then there’s the supporting evidence of Obama saying this legislation worth him not getting reelected over…