A lot of my work involves negotiating very complex legal documents with my clients. While one may think that the negotiators are fighting one another on behalf of their institutions (me, the bank who will lend the money and my client, the investors who want to build the project and usually want as much of it to be paid by debt rather than the equity they put in), the reality is that the negotiators are fundamentally together in the deal, and trying to work together to find a deal that works for each of their institutions. The goal then is to find an agreement that will be sellable to both sides. And "sellable" means approved by the decision-making bodies of each side, in this case the Credit Risk Committee of the bank (which approves or rejects loans) and the Investment Committee of the investors group, which decides to go ahead with a project or not.
The negotiators' job is thus to know exactly what their decision body is able and willing to do and to get a deal that fits within such constraints, while being compatible with the other negotiator's announced constraints. Or get a better deal, of course, if possible.
Looking at the healthcare debate, it's interesting to try to understand the negotiating dynamics. The first question is, of course, who is negotiating what on whose behalf?
There are two explicit decision bodies - Congress, which has to pass a law, and the President, who has some room to sign it into law or not. Both are themselves subject to 'oversight' bodies - directly, the voters, and, indirectly, the moneyed interests that provide means to obtain votes. Congress itself is an entity where decision making follows (i) internal procedures and (ii) majority rules, and thus the actual decision makers are the groups that (i) control internal procedures to the extent that a decision may be taken or not, and (ii) those that can make or break a decision by switching from one side to the other.
Is it a negotiation between the White House and Congress? Between Republicans and Democrats? Between Blue Dogs and Progressives? Between select members of specific committees in the Senate? Or, maybe, between citizens and health insurance companies?
Here, it makes sense to try to distinguish between principals (those taking the decisions) and the agents (doing the negotiating). So who are the principals? I think we can safely narrow these down to citizens (who want major change) vs healthcare insurance companies (who want to avoid change as much as possible). The difficulty is that these are both represented by Congress and both influence the White House. But ultimately, one can argue that citizens are represented, today, by the Progressive Caucus in the House, while insurance companies are represented by the Republicans and blue dog Democrats in both Houses - but that citizens, if upset enough, can penalize (to some extent) the Republicans and (to a larger extent) the Blue dogs for obstruction.
And the White House? They want a deal, one that is sellable to the citizens - but whether it's one which is actually good for the citizens is not really clear at this point (and whether that goal overrides the parallel goal of not pissing off the insurance companies is not clear either).
With the Progressive Caucus holding firm on what they want, we end up with a negotiation between the White House and the Congress committee insiders, under the supervision of, on one side, the blue dogs (on behalf of the insurance companies) and on the other side, the Progressives (acting for the citizens). (The Republicans, apart from a very small number of individuals whose position is not very different from that of the Blue Dogs, are out of the game given that they are against any deal)
If the White House were acting purely on behalf of the citizens, this would be a no-brainer: they would 'hide' behind the Progressive Caucus to ask for a more citizen-friendly deal. With both the Blue Dogs and the White House fearing the lack of a deal above everything else, the end-result should be close to what the Progressives want.
But if there are other considerations, ie that the White House is worried about what the healthcare industry may do in retaliation to a deal that they would consider as too damaging, then the balance becomes different - a deal would be somewhere halfway between the blue dogs and the progressive caucus - whether the "trigger" or some similar fudge.
From this we can deduct that the White House does not have solely the interests of the citizens as a priority. From the polls, it would appear that the citizens have noticed. What the White House will decide to do, in the end, will reveal if they think that their power ultimately comes from the citizens or from the corporations - and the next elections will reveal if that was the right negotiating stance.