Ross Douthat assumes that health care reform played a key role in the debacle, and asks:

Was the 111th Congress’s flurry of legislative activity worth the backlash it helped create? Were the health care bill and the stimulus worth handing John Boehner the gavel in the House of the Representatives? Did it make sense to push and push and then keep on pushing, even after the polls and town halls and special-election outcomes made it clear the voters were going to push back?

I don't think that the decision to pursue health care reform was a bad one. Obama ran on health care reform. This was the holy grail of Democratic policy for 60 years, and if Douthat wants to imagine the base's response to Obama deciding not to do it with huge majorities in each house, he should imagine a Republican president appointing an openly pro-Roe v. Wade Supreme Court justice when they are 4 votes to overturn the decision. And the public as a whole demanded it as well. In February of 2009, the public by 59%-12% favored health care reform. They may have turned against the bill as it dragged through Congress, but they always insisted that some kind of reform happen. (That's why Republicans had to disingenuously couch their opposition as a plea to "start over.")

But let's accept Douthat's premise for a moment that the decision to pursue comprehensive health reform hurt Democrats. Would I accept the trade-off? Yes, I would. Chances like this simply don't come along very often.

I'd also note that the decision to pursue a comprehensive plan was as much a GOP choice as a Democratic choice. Numerous Democrats in the Senate were desperate for bipartisan cover and only mildly committed to comprehensive reform. If any Republican Senators had put a deal on the table, almost any deal at all, however puny, at least one of those Democrats would have jumped at it. But Republicans were following Mitch McConnell's astute analysis that any bill with bipartisan support would become popular, and thus that withholding bipartisan support would hurt the Democrats but not Republicans. Republicans persistently followed an all-or-nothing strategy, and Democrats took all.

Which is to say, if Douthat is correct about his political premises, both parties had to choose between politics and policy. Democrats could have minimized their losses at the cost of sacrificing the health reform they wanted. Or Republicans could have minimized the scope of health care reform, at the cost of minimizing their potential wave. Democrats chose the best policy, and Republicans chose the best politics. I'm happy with the choice. Mitch McConnell won his election, and Democrats won health care reform. The latter is going to around a lot longer than the former.