Balance of Power

“I think that would wreck our health care system and wreck the Democratic Party if they did that,” said Alexander. The intensity of emotions at Republicans’ town hall meetings on health care over the recess, he said, has been “like nothing I’ve ever seen.”

Of course, it’s not like the Finance Committee Republicans who have been negotiating with Chairman Max Baucus of Montana have made life easy for President Obama and the Democrats either. So Democrats and their supporters will argue that they’ve already tried everything they could to offer concessions to Republicans — even though, as they’ll remind everyone, the Republicans lost two elections in a row.

Still, Alexander was acknowledging a genuine set of obstacles for Democrats if they go the reconciliation route. When any social change on the scale of the health care overhaul happens — especially something as personal to all Americans as health care — and one party is pushing it while the other is telling the country to be scared of it, you can bet it won’t go down easily. And whenever the first thing goes wrong with the overhaul, as it inevitably will, Democrats could pay a heavy price if the nation doesn’t have leaders from both parties saying this was the right thing to do.

“When you’re considering a once-in-a-generation accomplishment of the magnitude of health care, it should be expected, it should even be desired, that you have to get a buy-in from the public,” Ralph Neas, chief executive officer of the National Coalition on Health Care, said recently.

The White House and Senate Democrats may decide to use reconciliation because they have no other choice — because Republicans refused to join them. But if so, the long-term success of the overhaul could depend on whether they have a backup plan for getting that public buy-in — and being able to bank on it when things go wrong.