Diagnosis

The problem: Nearly all Republicans and many blue dog Democrats are opposed to health care reform. They are unwilling to do anything that might provide universal health care. The Republicans' opposition stems from the fear that people might actually like the public option. The conservative Democrats' from the fear that their constituents might vote them out of office before they find out they like it.

This loose coalition of conservatives can't come right out and say they oppose reform, but their every behavior shows it. Without a real public option, anything labelled health care reform is fakery. Mitch McConnell knows what he's doing. So does Jim DeMint.

As Nancy Pelosi says, insurance companies have had long enough. They have provided no progress toward universal coverage at all. Paul Krugman argues that the market fundamentally cannot provide universal coverage (although you'll notice he does not say that market mechanisms are completely useless).

Unfortunately, the prognosis is starting to look grim. There doesn't seem to be a working majority for any significant reform, so we may get a few portability fixes and big giveaways for the insurance industry.