The one thing that seems to be missing from the discussion of whether the House Dems will vote on the bill already passed by the Senate or will simply agree to kill health care reform for the foreseeable future, is what "health care," as an issue, means to the left in American politics. As an abstract issue, "health care" is an issue that tracks very well in the polls when there is nothing concrete about to be passed by Congress. For Democrats, it is a handy issue for when it is in opposition, something it can use to establish its populist bona fides, since the issues involved (coverage, cost, access, etc.) are concerns that affect the great mass of people. And as a matter of rhetoric, it is something that even a Blue Dog/Dixiecrat can support, at least on the campaign trail.

But when progressives actually attempt to do something to match their rhetoric, they find that it is nearly impossible to pass anything. Public opinion is easily fooled, especially when powerful business lobbies are involved, and on those few occasions when liberals have all their ducks in a row and can actually enact something, they discover that an issue that works pretty well when they are out of power, is more of a cancer when they have to take the reins.

So the fact that progressives in the House are abandoning the bill shouldn't be much of a surprise. As an issue, calls for universal health coverage are to progressives what opposition to abortion rights is to the right: something to advocate, not enact. Because once something like the Senate bill actually becomes law, the issue, and its usefulness as a vote-grabber, disappears. Not getting a bill enacted isn't the big surprise; the big surprise is that progressives went through the motions in the first place.