Still, there are enough differences between the House bill and what the Senate has already essentially agreed to that liberals are troubled. Ignore the thorniest question, what to do with the public option; that still leaves a slew of other issues, from the Senate's plan to tax expensive healthcare benefits to pay for expanding coverage to the House's more generous expansion of Medicaid eligibility to poor people.

The public option, though, tops the list. Grijalva said he didn't think much of the reported deal to remove it from the Senate bill, though he doesn't mind the plan to let uninsured people between the ages of 55 and 64 buy into Medicare -- as long as their premiums are affordable and the move doesn't jeopardize the system's already precarious finances. If the Senate is hung up on the name, though, progressives don't care what a public plan is called. "Call it what you want to call it," he said. "If it provides that coverage and that intent, it has some public oversight and owernship to it, then we're in favor."

But even though the details aren't set yet, progressives are preparing to defend their goals. Liberal Democrats have been meeting frequently with House Speaker Nancy Pelosi (though Grijalva says they don't hear from the White House much), and they'll keep the pressure on. "People are reluctant, at this point, to say 'I'm going to draw this line in the sand and say if this isn't in, then I'm out,' because there's no details," Grijalva said. "We keep hearing, 'Wait till it gets fleshed out.' You need to plan for the worst-case scenario here; given past performance by the Senate, you gotta plan on the worst-case scenario."

"Well, what I said -- it is a two-part statement that quotes what the President has said. We believe, we in the House believe that the public option is the best way to hold insurance companies honest -- to keep them honest and also to increase competition. If there is a better way, put it on the table," Pelosi said at her weekly press conference, in response to a question about her August comments.

"As soon as we see something in writing from the Senate, we will be able to make a judgment about that. But our standards are that we have affordability for the middle class, security for our seniors, closing the donut hole and sustaining the solvency of Medicare. Responsibility to our children, so not one dime is added to the deficit. And accountability of insurance companies. We will take a measure of that bill in those regards."

These comments are being portrayed as Pelosi outright abandoning the public option. Clearly, she wasn't quite that definitive. But she's certainly leaving the door open to the Senate deal, and -- especially given these remarks -- it wouldn't be at all surprising to see her come out in support of it fairly soon. If the agreement is the only way any bill passes the Senate, it's not like she has much choice in the matter.

Things are different now. Republicans think, and rightly so, that they're in a much stronger position on healthcare than they were when Luntz penned the memo that contained those words of wisdom. So their rhetorical strategy has shifted, and now it's at the point when top Republicans have no problem admitting to exactly the dynamic that Luntz warned against.

In a memo of his own, published Thursday, Republican National Committee Chairman Michael Steele wrote:

I urge everyone to spend every bit of capital and energy you have to stop this health care reform. The Democrats have accused us of trying to delay, stall, slow down, and stop this bill. They are right. We do want to delay, stall, slow down, and ultimately stop them from experimenting on our nation’s health care. And guess what, so do a majority of Americans.

Steele's often off message, but not this time. With polls trending away from President Obama, and having seen the anger on display at the town halls this summer, the GOP's content to let everyone know their plan.

That doesn't mean Democrats won't try to make them pay for it. In a statement, Democratic National Committee Press Secretary Hari Sevugan said:

With this memo and Senator Judd Gregg's obstruction manual, Republicans have laid their cards on the table and made explicit that their intention, their singular goal, is obstructing the President's agenda for the sake of politics no matter how high the price for the American people. They've made the choice crystal clear for voters -- while Democrats are working to get things done for the benefit of the American people, Republicans are obstructing progress for the benefit of themselves and their special interest allies. If they think that's a winning proposition, they are in for a world of hurt.

To provide political cover to senators who want to tell their constituents that the intent behind a robust public option lives on, the emerging Senate bill makes Medicare available to younger folk (age 55), and lets people who aren't covered by their employers buy in to a system that's similar to the plan that federal employees now have, where the federal government's Office of Personnel Management selects from among private insurers.

But we still end up with a system that's based on private insurers that have no incentive whatsoever to control their costs or the costs of pharmaceutical companies and medical providers. If you think the federal employee benefit plan is an answer to this, think again. Its premiums increased nearly 9 percent this year. And if you think an expanded Medicare is the answer, you're smoking medical marijuana. The Senate bill allows an independent commission to hold back Medicare costs only if Medicare spending is rising faster than total health spending. So if health spending is soaring because private insurers have no incentive to control it, we're all out of luck. Medicare explodes as well.

A system based on private insurers won't control costs because private insurers barely compete against each other. According to data from the American Medical Association, only a handful of insurers dominate most states. In 9 states, 2 insurance companies control 85 percent or more of the market. In Arkansas, home to Senator Blanche Lincoln, who doesn't dare cross Big Insurance, the Blue Cross plan controls almost 70 percent of the market; most of the rest is United Healthcare. These data, by the way, are from 2005 and 2006. Since then, private insurers have been consolidating like mad across the country. At this rate by 2014, when the new health bill kicks in and 30 million more Americans buy health insurance, Big Insurance will be really Big.

In light of all this, you'd think the insurance industry would be subject to the antitrust laws, so the Justice Department and the Federal Trade Commission could prevent it from combining into one or two national behemoths that suck every health dollar out of our pockets (as well as the pockets of companies paying part of the cost of their employees' health insurance). But no. Remarkably, the Senate bill still keeps Big Insurance safe from competition by preserving its privileged exemption from the antitrust laws.

From the start, opponents of the public option have wanted to portray it as big government preying upon the market, and private insurers as the embodiment of the market. But it's just the reverse. Private insurers are exempt from competition. As a result, they are becoming ever more powerful. And it's not just their economic power that's worrying. It's also their political power, as we've learned over the last ten months. Economic and political power is a potent combination. Without some mechanism forcing private insurers to compete, we're going to end up with a national healthcare system that's controlled by a handful of very large corporations accountable neither to American voters nor to the market.

"My name is Christopher Dodd," he deadpanned to a crowd of reporters clustered just outside the Senate chamber on the Capitol's second floor. "That's all I can give you, name and serial number."

After more than a year of legislative wrangling on healthcare reform, Senate Democratic leaders suddenly appear to be taking the old cliché about Congress -- that writing laws is like making sausage, and you wouldn't want to see either one up close -- fairly literally, and applying it to their own herd, to boot. Most Democratic senators pleaded ignorance Wednesday to even the most basic questions about where the reform bill is heading. Did a group of five liberals and five moderates reach a deal late Tuesday to pull most of a proposed public health insurance option out of the reform bill, replacing it with an alternative package? What, exactly, would that package look like? And -- most important -- did all the tinkering finally lock up the 60 votes Democrats need to push reform past what's guaranteed to be the mother of all Republican obstruction efforts? The prevailing answer to all of that out of aides and lawmakers alike Wednesday was: Gee, we don't know yet. And we won't know, until the Congressional Budget Office says what the ideas under consideration might cost.

"I think there are very significant issues that have yet to be worked out," said Vermont Sen. Bernie Sanders, an independent who caucuses with the Democrats. "There are still, from my perspective, some major unanswered questions." Fair enough -- Sanders was not one of the 10 people who have been working on the deal that leaders announced Tuesday night. But Sen. Blanche Lincoln, D-Ark., was one of the negotiators -- and she told reporters Wednesday that nothing was settled: "There was no compromise."

Actually, the outlines of what the group came up with are fairly clear. The public option in the bill now -- as one of a handful of insurance plans uninsured people could choose out of a new exchange to be set up -- would be dropped. Instead, the exchanges would offer a selection of national, nonprofit, but privately run, insurance plans curated by the Office of Personnel Management, the federal agency that handles health benefits for government workers. Uninsured people between the ages of 55 and 64 would also be able to buy into Medicare if they wanted, expanding a program that has never before covered anyone under 65. If private insurers didn't offer premiums cheaply enough to meet some as-yet-unspecified standards, a national public option would be "triggered" into effect. The legislation would also expand Medicaid to cover about 15 million more people than it does now.

But the devil, as they say, is in the details. And no one has them yet. Democrats sent several proposals to congressional budget wonks for a cost estimate; the results of that experiment will determine the specific direction the legislation takes. Conservative Democrats like Nebraska Sen. Ben Nelson and North Dakota Sen. Kent Conrad worry that expanding Medicare could hurt doctors and hospitals, who already complain that the government program doesn't pay them enough for services they render, and bankrupt the government in the process (though that always seems to be Kent Conrad's worry). Progressives fear the private plans won't come close to bringing down costs for people who can't -- or can only barely -- afford insurance now. No one seems to know how much the new Medicare patients, for example, would be asked to pay in annual premiums, or how the government would reimburse providers for their care.

Even once the policy questions get answered, that still leaves political questions. The whole point of the compromise was to pick up a handful of votes that have, so far, eluded Senate Majority Leader Harry Reid, especially from Nelson, from Connecticut Sen. Joe Lieberman, or from Maine Republican Olympia Snowe. Nelson said Wednesday that the outlines of the deal sounded better to him than the previous proposal, but wouldn't commit one way or another to it. Snowe -- the only GOP member who's really considered a possible supporter of the reform plan -- seems not to like the Medicare buy-in proposal. And Lieberman, whose 2008 campaign heresies Democrats let slide last year, is doggedly insisting that even a trigger for a public option would be an unacceptable affront to his principles.

Progressives, meanwhile, aren't exactly rushing to sign on with the new plan, either. MoveOn.org e-mailed an urgent action alert to its members, asking them to sign a petition demanding that Democrats save the public option. Influential liberal bloggers came out against it, as well. Labor unions say they'll still insist on a strong public option. House Democrats, who have already approved a bill with a public plan, aren't happy. "At some point in this process, the question became not what was the best policy for the American people, but what could be done to appease a recalcitrant handful who have negotiated in bad faith," said Rep. Raúl Grijalva, D-Ariz., the co-chairman of the House Progressive Caucus.

Even some of the Senate liberals involved in the negotiations sound less than thrilled with it. "The current negotiations are very intense, and compromises are often difficult," said Sen. Jay Rockefeller, D-W.Va., in a written statement just before the evening caucus meeting started. "My final assessment will be of the bill as a whole and my approach on the public option is to stay focused on the goals rather than the title or label of good policy. While I firmly believe a strong public option is the best and right solution -- there are other ways to solve the core problems of affordability and accountability in our broken healthcare system." Vermont's Sanders told me he's worried that expanding Medicaid without doing something to expand access to cheap, but effective, community health clinics could leave 15 million people with insurance they can't use. "That looks good in the newspapers, but it doesn't look good in reality," he said. The Senate bill's plan to tax expensive "Cadillac" insurance plans still doesn't sit well with Sanders, either. "With the cost of healthcare zooming up the way it is, these so-called Cadillacs are going to be junk cars in a few years."

Sanders still thinks the country will eventually have to move to a single-payer healthcare system in order to cover everyone and restrain explosive costs. But figuring out how to work that out isn't something the Senate is anywhere near ready for right now. At the moment, Democratic leaders seem to have more than enough vexing questions facing them to take just these first few steps toward reform. And for now, they would settle for just a handful of answers.