Given the current configuration of Congress, the fate of health care is likely to depend, in the end, on the incentives confronting conservative Democrats. If they feel that passage of a particular version of “health care reform” will strengthen their re-election prospects in 2010 or 2012, it will probably pass. If they don’t, it almost certainly won’t. The president, of course, has a role to play in trying to shift those incentives by swaying public opinion. But that’s an indirect route to influence, and one in which he’s competing with a lot of other people who know how to play this game.

Greg Marx is a CJR staff writer. Follow him on Twitter @gregamarx.