It's not about Hitler, Stalin, or Mao. It's not about saving Medicare or patient's rights. It's not about creeping socialism. It's not even about saving the insurance companies - except perhaps in the case of those congresspeople on both sides of the aisle whose palms have been well and truly greased (aka Graft to the Max).
My diagnosis is below the fold.
The public option will be the first major expansion of entitlement since the 1960s. Think about that. It's been two generations since Medicare and Medicaid were signed into law. For the past thirty years, Republicans have swung hard to the right and Democrats, with few exceptions, have followed.
This is the swinging of the pendulum of history. This is the chemotherapy for the cancer given by Reaganomics.
Reagan said that the Government can't solve problems - that the Government is the problem (incidentally - he was quite right. He just failed to point out that it's only the case with Republican governments).
A successful government run health insurance plan would put the lie to thirty years of anti-government propaganda shouted by Republican government officials. It's not a lie that people will readily forgive. Health care reform will lead to regulation reform and the rolling back of the tragic experiment that began in the 80s. They've worked hard, won victories small and large, and almost managed to undo the New Deal.
Imagine that - get rid of the regulations put in place after the Great Depression, and watch as the country returns to Gilded Age level inequality leading finally to an economic disaster of Biblical proportions. Health care reform - including a strong public option - will mark a return to the democratic (small d - they were Democratic ideals, but they were also an embrace of true democracy over plutocracy) ideals that were the hallmark of the FDR era.
This is the Reaganite swan song. They won't go down easily - they governed ugly, and they'll fight ugly to try to stave off extinction for another election, another year, even just another month. This is a fight they've lost, but they'll scorch the Earth behind them if they need to.
But we'll win, because we have to.