After months of plot twists and legislative brinksmanship, the United States is once again close to passing health-care reform. The surprising Act V turnaround by Barack Obama and the Democrats provides a lesson in how to manage political conflict and overcome entrenched opposition.
Mr. Obama saw his first reform bill evaporate when the seat held by the late senator Ted Kennedy fell in a special election to Republican Scott Brown, leaving Democrats one vote short of the 60 needed to avert delay tactics by Senate Republicans, who were universally opposed to the bill. His grip on House Democrats weakened, with anti-abortionists and liberals each throwing up objections.
The decision to try health care reform in the first place confused many loyalists. Many thought Mr. Obama should spend his political capital on tackling joblessness or financial reform. And with Mr. Brown's victory, many said the lesson was to be more conciliatory, and to moderate the reform's ambition.
Rather than ceding the agenda, Mr. Obama redoubled his efforts. In private, he worked more closely with Congressional allies, realizing that the previous strategy of leaving most of the details to them had failed.
His public political stagecraft included a summit with Republicans, showing his commitment to a solution that could, on the right terms, include them. In speeches, Mr. Obama relayed the personal tales of suffering by those without health care insurance, and the collective story of pending rate increases that dominant insurance companies were about to foist on their policy-holders.
Mr. Obama seized the public agenda by assuming leadership and telling stories that conveyed a richer, more compelling narrative than the misleading buzzwords - "socialism"; "death panels" - of his opponents. The stories, and the values that underlay them, made the moral obligation to reform health care vivid and urgent, while the opposition could summon no similar positive vision.
It was a great effort by Mr. Obama and House Speaker Nancy Pelosi, but in service of the modest objective of securing enough House Democratic votes to assure legislative success. Moreover, the likely result hews in most ways to the original plan: extending benefits to millions of Americans without resorting to a government-backed insurer, and without aggressive moves to rein in health-care cost increases.
The success, though, could be one not just for health care, but for the political system. Should the opposition to reform fail in the coming days - a failure that is in no way guaranteed- and should the public begin to enjoy the benefits of reform, the Democrats will have shown that politics can work. In a system many see as broken, that is a result worth the fight.