Democrats should be concerned about their path forward with health care reform. The current Senate bill is very unpopular as a result of bad policy decision on the part of Democrats combined with poor messaging. Taking out the popular public option — while fighting to keep the very unpopular individual mandate as well as the excise tax on benefits — was an extremely stupid political decision. If Democrats choose to pass health care reform they should be focused on how to make sure the bill has as many popular provisions as possible and as few unpopular provision as possible. What they should not worry at all about are Republicans senators, like Lamar Alexander (R-TN) spewing nonsense about the legislative process.

Alexander said that Democrats using reconciliation would be a “political kamikaze mission” and that would basically be the “end of the Senate”.

It would turn the Senate, it would really be the end of the Senate as a protector of minority rights, the place where you have to get consensus, instead of just a partisan majority.

I’m not going to address the factual absurdity and completely hypocrisy of his statements given that Republicans have used reconciliation repeatedly because the American people don’t care about Senate procedure (others have already covered this). It is not just that American don’t care about Senate process; they don’t even know what it is. Most American don’t know what cloture means and how it works as related to the Senate. It’s doubtful that as many as one in 10 Americans could name two bills that passed using reconciliation; nor could many citizens tell you have many votes big bills like Medicare, SCHIP, or No Child Left Behind got in the Senate when these initiatives were created.

It is too late for Democrats to worry about Republicans screaming nonsense about this or that procedure. They have known for months they were not going to get Republican cover and should have prepared accordingly. Republicans will attack Democrats regardless of what they do – they are acting as an opposition party, opposing absolutely.

If Democrats do pass health care reform what the vast bulk of Americans will hear and/or probably remember is that at most Democrats passed a health care bill with A, B, C, and D. Exactly what these three or four things are is critical. If A, B, C and D are popular, it’ll be a win for Democrats. A win could include closing the donut hole, a public option, a ban on exclusions of pre-existing conditions, tax credits for small businesses, Medicare buy-in, employer mandate, etc. Any of these things are popular and passing them will help the public’s perception of Democrats. But if the items A, B, C, and D included in the health care bill are unpopular, Democrats will be crushed in 2010. For example things like individual mandating forcing you to buy private insurance, new taxes on your health care benefits, secret deal to drug companies, cuts to Medicare, etc…these would be very bad. At this point Democrats should count it a win if people remember the bill as being a mix bag of good and bad provisions.

Politically the sole thing Democrats should be focused on is not process but defining what A, B, C, and D are in the public consciousness. They should make a point to strip anything big and unpopular they can like the individual mandate, the excise tax, and the Cornhusker kick back; they need to send strong messages to the public about adding in big popular provision like a public option, Medicare buy-in, and drug re-importation. Defining what are the three or four things people remember being in the health care bill is what will make or break Democrats — not insider baseball talk about Senate procedure that most regular Americans don’t know about, don’t understand, or don’t care about.