Backing away from his original intent to press both houses of Congress to pass a reform bill by the beginning of August, President Obama is hoping to “fight our way through the politics of the moment” and “…pass reform by the end of this year.” That’s the least of his concerns. With public pressure mounting and his approval numbers on the issue falling, pullback on the president’s part is inevitable.

This blog has recently noted the effort of physicians to have a say in these eleventh hour negotiations. It appears that one of the more august healthcare organizational bodies is doing just that — the Mayo Clinic.

Even as Mr. Obama sought to answer critics, the Mayo Clinic, cited by the president and lawmakers of both parties as a model, criticized the House health care bill on Monday, saying, “The legislation misses the opportunity to help create higher-quality, more affordable health care for patients.” …

“Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither,” the clinic said.

On the legislative front, the House proposal for a surtax on the wealthy to provide an economic buffer appears to be stalling in the face of Senate disapproval of the issue. All of this, Obama probably did not expect during the campaign trail. Back then, it was easy to sell healthcare reform to the American public. After all, it was part of Obama’s big prescription for Change — though, without all of the specifics.

How things change. Not only is the drive toward definitive reform encountering the type of partisan pressure the president hasn’t had to encounter (until now) in his young presidency, it is become increasingly, well, political. That’s too bad, because the one unifying factor in the once-overwhelming approval of Obama’s healthcare plan was the moral obligation to guarantee healthcare delivery to everyone.

Currently, that notion is in serious jeopardy, as all parties with a stake have their own ideas for what constitutes healthcare reform — and it really has nothing to do with patients, physicians, or their concerns.

Even among Democrats, there’s no consensus. In the House, they want a surtax on the rich. In the Senate, the Finance Committee chairman wants to tax health care benefits. And some conservative Democrats are voicing concerns after a new budget analysis by the nonpartisan Congressional Budget Office revealed the leading Democratic health plans will increase the debt and not provide the savings Obama promised.

Yep, that sums things up nicely. Could Obamacare go the way of Hillarycare? Probably not entirely, as we all learn from our mistakes. It’ s called conditioning. The problem for Obama is, however, whether he can condition himself for his first truly domestic challenge for whatever the fallout on this issue may be.

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