Lillis argues that single-payer health care should have been Democrats’ starting point in the quest for reform. Not because the single-payer system would have been a viable goal, but because anything else would have appeared moderate in comparison; for example, say, a public option.

Democrats pushing for a government-backed insurance option as part of their health reform strategy are finding out the hard way that, by taking single payer health care off the table early, they have little leverage now to force a strong public plan.

Unlike the Republicans, who adopted the strong conservative position of resisting almost every Democratic reform proposal from the start, Democratic leaders ruled out the liberal single-payer proposal early in the debate. Now in search of a centrist compromise, GOP leaders have plenty of room to maneuver, while Democrats are left facing proposals that either dilute the public option or eliminate it outright.

. . . By choosing the public option — not single payer — as the left-most negotiating point, Democrats left themselves with few places to go but toward more conservative proposals for insurance reform, experts say, including the co-op model and a system of triggering public plans only if private insurers fail to meet certain cost and coverage targets.

This makes appalling sense to me. Lillis goes on to point out that the key in Washington is to “over-ask” and then negotiate to your goal. This is Negotiation 101, right? So has the White House miscalculated in leaving the bulk of the “how” to lawmakers who were too timid to over-ask? Or did the White House expect that, by giving the “no haggle price,” colleagues across the aisle would simply say, “Oh, okay, that sounds like a good deal”?

That seems to be where current evidence is pointing. Single payer is a political nonstarter (today, at any rate), and the White House knows this. But Obama probably could have taken that risk (he wouldn’t be doing any worse now in public opinion polls) and asked a core group of Dems to write single payer into a bunch of drafts that everyone knew would be shredded in committee rooms and on the Sunday shows. But imagine how that would have framed the entire debate over health care as each faction played its proscribed role. Liberals would have squealed and given the president high marks for even mentioning the words. Blue Dogs would have balked, but they’d have seen how the president gave them room to play the good guys in the debate. Conservatives would have been outraged by single payer. They’d have demonstrated in the streets and rallied against big government, socialism, liberal spending sprees, government getting between patients and doctors . . . Who knows what craziness might have emerged? Wingers would have decried government “death panels” as a result of the single-payer system.

And then, from the ruckus of reactionary debate, a moderate voice would have piped up just after the August recess. Maybe it would be the president. Maybe it would be a seasoned congressional leader: A single-payer system, despite the fact that it works well for England, Canada, France, the Netherlands, Japan, Germany, Ireland and many more nations we consider prosperous allies, is not what Americans want or need. The majority of Americans who have insurance are happy with their insurance, and we want you to keep what works. That’s why we’ve decided to unveil a “public option.” This public option will allow you to keep the insurance you are happy with, buy quality affordable insurance if you currently aren’t covered, and it will create competition in the market by introducing a nonprofit model that will force the big, wasteful insurance companies to be more careful with your money if they want to stay in business.

Whew. That would have been sweet. Conservatives would have been up in arms, of course, and all the same rhetoric would have blared from the Republican machine. But we’d have heard it before, and thus the talking points would have lost their edge. Max Baucus, who might still be holding out for some whiff of bipartisan smoke from his finance committee bill, could have looked around the table and said “Okay, single payer is out. We’ll give you that. But the public option is good, it’s sound, it answers calls for compromise. So let’s get to work.”