The fundamental problem in health care reform is that there are too many issues at the table and that too many different actors with different preferences.
What's worse, these actors are divided into groups working on things in secret which only at the second stage will be merged together. So even if group A can agree on something, they must then merge their proposal with group B's agreement. But it is likely that these will not be mergeable and there is an alternative, C, which is less acceptable to both group A and B than A and B's plans, but is more acceptable to the combined A and B than either of A and B's plans.
C could barely pass A and B combined, but it will never be reported out of A committee or B committee because plan A > C in A committee, and B > C in B committee.
See where I'm going here?
Basically, legislation is a logic problem. Specifically, it is a social choice problem. What Obama needs is not politicians but to bring in academic experts on social choice.
Suppose options are I, II, II, and IV. These options can be combined into proposals, which represent mathematical combinations (I is a combination, I & II is a combination, I & III is a combination, I & II & III is a combination, and so on...)
Members are A, B, C, and D. Each member has a preference (he prefers combination of I & III > I & II > I & II & III; she prefers combination I & II > I & III > I & II & III, etc.)
The solution then,
- A database of all options on the table
- A database of all members
- Send a survey to each member asking them to rank their preferences
Use a computer to calculate those possibilities that will result in in the majorities needed.
Politics is more complicated than this, you say? More nuance? Sure. But all I propose is that you use this as a starting point. I mean, these social choice people have been in academia for decades, it's time they put some of their theories to use for actual democracy, which could use it. It doesn't even need to be about health care only...