The Health Reform Train

The health reform train is nearing its final station. The nearer the station gets, the slower the train goes, the more remote the station seems, the more the station seems to be one of those political dreams, Obstacles litter its path. Barriers are political – only 17% of Americans list health care as their top issue; financial – the Office of Management and Budget has yet to clear the tracks; and legislative - getting 60 votes and traversing procedural terrain grows more difficult. The train is running behind schedule. It may not reach its destination before Christmas Eve or New Year's Day.

Democrats on board are restless. Their staffs are texting and screaming on cell phones. Constituents are emailing, tweeting, and face booking to complain. As athey read damning polls, Democrats support dropping for midterm elections. Republicans are of no help. They sit glued to their seats. Occasionally they stand and sneak off to pull the emergency brakes. Democratic legislative leaders troll the aisles, trying to rustling up a vote or two. The Engineer-in- Chief stands in front of the train, seeking to talk and charm the litter off the tracks. His close crew is coaxing, promising, bribing, and even threatening the opposition, to remove litter that blocks the rails. Every litter bit counts, they argue, better to be part of history than lose your seats.