A cautionary note ..
Because Congress has passed bill after bill on Obama's wish list and because Democrats hold overwhelming majorities in both the House and Senate, some may think there can be no repetition of the fiasco of 1993-94, when Bill and Hillary Clinton saw their effort at health-care reform die without a whimper.
Insiders know better. Last week, I went to see the four top officials of the National Coalition on Health Care, perhaps the broadest consortium in the field, including labor, religious, professional and medical groups and a smattering of businesses. It has long advocated the kind of comprehensive overhaul of health care that Obama aims to achieve.
These advocates applaud administration efforts to engage the players in the insurance, hospital and pharmaceutical industries in their talks -- and the willingness of those groups to "stay at the table."
But once there is specific legislation, they say, each of these groups will start bargaining hard to protect its own interests. And some of them -- local hospitals, for example -- have real clout with members of Congress ..
Obama will have to carry much of the burden of advocacy himself -- if outside events don't intrude, as they did on Bill Clinton. The president has shown his willingness to bargain, signaling, for example, that he would now consider taxing some employer-provided benefits, an approach he denounced when John McCain endorsed it during the campaign.
But it will take much more than that to win what promises to be an epic struggle.
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