I remain optimistic that House Democrats are going to pass the Senate version of Health Care Reform. They're making all kinds of unfortunate noises about taking a break from the health care debate, but at the end of the day, they've already voted for a more-liberal version of the plan anyway, so I can't see any upside to voting against this one. If they do, they'll have all the same electoral liabilities they would have if they pass the plan, PLUS a base that would spit in their face sooner than knock on a door on their behalf.
The problem I'm worried about is, what happens once they pass the Senate bill? Since the pressure is overwhelmingly coming from the Left, and since Members apparently regard this as some sort of difficult vote, Congressional Dems will want to argue that now they don't have to do anything big that liberals like, since they'll have already stretched their necks out for us and now they need to protect their moderate/conservative flank.
That would be beyond galling, as the Senate plan is vastly inferior to what liberals wanted, but what's even worse than that is that the only reason we're even in this predicament is because Congress took so damn long to come up with legislation in the first place, and then took so damn long to get any votes on it to happen at all. Really, Democrats in Congress need to be embarrassed and ashamed, afraid of what's already happening to their base, rushing to pass this bill and looking for ways to make it up to us.
Instead, they're going to make us force them to grudgingly pass what we all know to be a terrible bill, and then hold that over our heads whenever we try to get them to do anything else they should be doing in the first place.
It's all very frustrating, but I'm beginning to think it's inevitable for a political movement like contemporary American liberalism: since we're the ones identifying societal problems, we're the ones who actually want to do new things, which are always harder to do than old things. As an example: a national mandate to purchase health insurance from a private insurer is literally without precedent. Nothing like that has ever happened before in the US. Since it's never been done before, everyone's afraid of it, it sounds really weird, there are all sorts of institutional impediments to doing it and, since it's without precedent, it's unclear whether it's even constitutional (for the record, it almost certainly is; but "without precedent" means what it says, so who knows what the Supreme Court will hold.)
This is a general problem facing the party of action. In any debate, if one side says "We need to change X" and the other side says "We need to stop changing things like X", the latter always has the easier burden of proof. Most people remember the past fondly, and in the past we didn't have X and everything worked out fine, so do we really need it after all? And since we've never tried it before, isn't there some risk it could lead to catastrophe? We know we've been ok going without X; but maybe, doing X will tip us over the edge into socialism/fascism/totalitarianism/vegetarianism/somethingbadism. It's always harder to do something than to not do anything.