"Sometimes Democrats can be their own worst enemies, Democrats are an opinionated bunch ... y'all are thinking for yourselves," he said. "I like that in you, but it's time for us to make sure that we finish the job here. We are this close and we've got to be unified."

Obama said "the bill you least like in Congress right now, of the five that are out there," would give 29 million uninsured Americans health care, would ban preexisting conditions and would create an exchange that would encourage competition among ensurers.

But what these exhortations to practicality always miss is that this is a two-way street. If you think the public option isn’t that big a deal and it’s not worth spiking health reform over it, then you ought to think that it’s not worth spiking health reform in order to kill it either.

So far there’s been basically no pressure in the media on members who take this position to justify their extreme level of opposition. I get, for example, that Kent Conrad supports the Finance Committee version of health care and opposes adding a public option to it. But suppose a public option does get added. Does that suddenly take a vast package of reforms that he played a key role in crafting and turn it into a terrible bill? Why would that be? Surely Conrad is as aware as anyone else in congress that in order to pass a large, complicated health reform bill many senators are going to have to vote “yes” on a bill that contains some provisions they oppose. After all, the health reform bill contains hundreds of provisions! Are moderate members really so fanatically devoted to the interests of private health insurance companies that they would take a package they otherwise support and kill it purely in order to do the industry’s bidding on one point?