It's a political reality that the corporate interests who have made such a mess of our health care system also have a stranglehold on our Congress. They dominate the Republican Party and they have massive influence in our Party.

Among the most dozen or so conservative Democratic members of the Senate, it's impossible to find more than few who don't act consistently to serve the interests of the Insurance, Pharmaceutical and other corporate health lobbies. These Senators wield enough collective political power on behalf of these interests so as to have an effective veto over any sort of health care or insurance industry reform. They have for many many years. As a practical political reality they have to be negotiated with on any such bill.

This political reality existed before Obama won the Presidency and it still exists now. There was no 60 seat magic or possibility of slipping in just a few more progressives that would have changed this. Obama knew before he even won that if he was going to "do" health care reform he would need to strike a deal with the very interests who had broken the system. The political reality was and still is that these interests are so powerful in our system that they had to be given "a seat at the table."

We are now beginning to see the outlines of the deal being struck. It includes a lot of painful and expensive shape-up requirements for the Insurance Cartels, no doubt. In exchange it appears to insure the long-term survival of the industry, and to apply what they feel to be adequate nails to the coffin of single-payer, public-option, Medicare expansion or any other government-centric alternative. That's the big trade-off here. Shape up, and in exchange you never have to ship out.

To suggest that no grand deal between Industry and Obama is taking shape in this bill is to bury one's head in the sand. It's not like it's some secret who the blue dog Democrats in the Senate serve. Obama always knew he'd have to deal with these guys. Now he is.