Why the health care debate is so important regardless of one's view of the "public option"

The New York Times today has a discussion from several contributors, including me, of the politics of the health care debate. My contribution, which focuses on the role the White House has played and the ample evidence that they have been quite active in shaping the course of events, can be read here. I want to elaborate on a couple of points I referenced in passing.

Over the past decade, the Democratic Party has specialized in offering up one excuse after the next for its collective failures. During the early Bush years, the excuse was that they endorsed Bush policies because his popularity and post-9/11 hysteria made it politically unwise to oppose him. In later Bush years when his popularity plummeted, the excuse was that Democrats were in the minority and could do nothing. After 2006 when they won a Congressional majority, the excuse was that Bush still controlled the White House and had veto power. After 2008 when a Democrat won the White House, the excuse was that Republicans could filibuster.