The failure of the Senate Majority Leader Harry Reid to rally his troops and pass yesterday’s vote on Medicare compensation for doctors may be more encouraging that I’ve thought. Yuval Levin, who knows this issue, assesses it this way:

The problem for Reid is more than substantive — more than unhappy doctors and an unhappy AMA. The biggest problem is the danger of losing the confidence of his Democratic senators. Passing health-care reform remains an extremely difficult challenge: There are two Senate bills, with very significant substantive differences between them, which need to be combined, voted on, then merged with an even more different House bill, and voted on again. Each of these votes would require the support of just about every (if not indeed every single) Senate Democrat, and each would be a very tough vote for one or another group in their caucus. It is an exercise in serial needle-threading that will call for an extraordinary degree of discipline by the Senate Democrats — a group not known for discipline. To work, it will require Reid to pressure nervous members, strike multiple precarious compromises, and hold it all together, which will require him to command a great deal of authority and confidence among his members. None of them wants to be left out in the cold having taken a tough vote on a very unpopular bill that still ends up going nowhere. Today’s vote showed these senators a leader unsure of himself, lacking an accurate vote count, and surprised by developments on the Senate floor — embarrassed and embarrassing. This is not what the Democrats need in the buildup to a very tense and complicated legislative maneuver.

This is a big part of why many on the Hill remain unpersuaded that the Democrats can pass something like Obamacare this year. Maybe Lyndon Johnson could pull off what they need to pull off in the next month or so. But Harry Reid is no Lyndon Johnson.

Michael Franc, also on National Review’s The Corner, also finds the vote highly significant:

How bad was yesterday’s vote loss for Harry Reid? Almost as bad as it was for the special-interest model he and other Democratic leaders have embraced for enacting health reform. The people, it seemed, spoke (and by the hundreds of thousands through phone calls and e-mails), forcing the AMA’s lobbyists to scurry back into their holes.

Between Monday afternoon and yesterday the vote on the doc fix morphed from a technical change to a complex reimbursement formula for physicians into a much bigger issue: about the proper size and scope of government, about the morality of passing along an additional quarter trillion in debt to future generations (not to mention a $3 trillion new unfunded liability for Medicare for a permanent “fix” to the formula). The moment this became a fiscal and moral gut check, the people prevailed and the special interests lost.

Now they know we, the people, are watching.