The U.S. media is excellent at cutting off the left from political debates. That way the moderates look like the new left end and the so-called center keeps on moving to the right. For an example, take a look at a USAToday article on Obama's coming speech on health care. It begins by stating the problems he has (people don't want reform yadda-yadda, despite what the polls tell us). Then comes this:
As he enters what senior adviser David Axelrod calls the "eighth or ninth inning" of the debate, Obama is caught between liberals who want to revamp the insurance market with a government-funded "public option" and moderates who favor an incremental approach.
Both efforts have stumbled. Health and Human Services Secretary Kathleen Sebelius said the public option wasn't essential. Six senators seeking a compromise ran into trouble after one, Sen. Chuck Grassley, R-Iowa, urged his donors to defeat "Obama-care."
Note how suddenly wanting a public option is labeled a) liberal and b) an extreme end-point. The correct end-point in the debate was a single-payer health care system, but the media has successfully erased that a long time ago, despite letting all sorts of right-wing memes stand as truths.
Of course a government option is an incremental policy. That it has become the bugbear of our political classes as pretty surprising. I guess the wingnuts are still worth fearing and in power, despite being a minority in both houses of the Congress.
What does the reform mean without a public option? My simple answer: Nothing. For a longer explanation, read my AlterNet piece on this.