It has come to this.  This deadline will come and pass.  It will not be met.  What happened?

Strategically, to frame health care reform as the defining and pivotal achievement of this administration was a setup.  The new administration entered under a wave of jubilation and hope.  I shared these sentiments.

In 1964, Lyndon Johnson entered the office of the presidency with a mandate for change.  A mandate to finish what had been started in the three previous years under an inspiring but a feckless young president.  Johnson was the consummate politician.  He knew how to twist arms.  He knew the Senate intimately.  As so aptly put by Linton Weeks of NPR:

President Johnson was famous for staring down, shaming, cajoling, strong-arming, coaxing, sweet-talking legislators into doing his bidding. Johnson spoke directly to lawmakers. Sometimes very directly. Through manhandling and manipulation, Johnson was able to push through legislation affecting public health for the elderly, fair housing, voting rights and other programs that brought sweeping social change.

Obama came in with a new agenda.  This was to be the reincarnation of Martin Luther King or Mahatma Gandhi.  Leading by example.  Without rancor.  But Washington is a shark tank.

To define health care reform as pivotal to the success of this administration was ill-conceived.  It was based on the concept that the president could appeal directly to the public in a populist manner, rising above the political turmoil.  But the message has become diffuse.  It is now confused lacking laserlike focus.

We were told the overriding motivation for reform was 40 million uninsured Americans.  But was this enough to motivate the remainder of Americans who feel they are covered?  Last night the president gave a flawed presentation.  “If you liked the system the way it is, you are guaranteed disaster.”

Over the last few weeks I have written extensively about the need to clarify this one simple question — how will this be funded?  We know Medicare is on the verge of insolvency.  It has been on the verge for the last decade.  And within next two years 76 million baby boomers will be eligible for Medicare.  Simply fixing the daunting economics of this entitlement program would be sufficient.  But to claim that we can add 40 million additional people to system that is already on the verge of insolvency simply does not add up.

It has the greatest of intentions.  It is a noble undertaking.  The goals are lofty and Apollonian.  But mythical.

Strategically, the political calculation should have anticipated the inevitable splintering of the Democratic Party.  This is its nature.  That is the nature of  the Democratic Party — fostering competing ideas.  This is not a monolithic party.  That is its strength … and its weakness.

This never was about health care reform.  This was about economics.   And bad economics.   The real crisis in this country is still the fallout from the financial crisis that has not been solved.   Maybe the paradigm was wrong.  It was not an emulation of Abraham Lincoln.  It was not an emulation of Franklin Roosevelt.  It should have been an emulation of Theodore Roosevelt — the great trust buster.

Politicians have only scant knowledge about the medical industry.  In fact they are witless.  That became abundantly clear last night in the president’s address.  This is not about red pills and green pills.   [Enter the Matrix]

Real healthcare reform is a paradigm shift.  We do not have a healthcare system.  We have a disease management system.  The true reform we are seeking is not economic — it is metaphysical.  New concepts — new paradigms — new thinking.

HealthCare reform would emphatically promote the … care of your health.  This starts with personal responsibility.

True reform would foster and encourage newer models of which Anti-Aging and Longevity medicine is the most successfully emerging model.    This model is market-driven.  This market is based on optimal health and well-being and not the absence of disease.  It is functionally based.  Restoring and rejuvenating.   Returning all of us to an earlier “you.”   It is goal oriented.   It has as its side effect, the prevention of unnecessary hospitalizations.

The current Strategy was  based on a rush to judgment.  We have seen this played out too often with ill results in the last 10 years.  This is the basis of the Shock  Doctrine.  All recent change has been a consequence of imminent danger and crisis.  It is shockingly motivating.   But it does not lead to useful or healthy solutions.  It leads to stopgap, ill-conceived and expensive solutions.

It is now time for a respite.  A reprise.

Round 2 to begin.