A year ago, I sat with other delegates at the Democratic National Convention and cheered when Barack Obama said in his acceptance speech: "Now is the time to finally keep the promise of affordable, accessible health care for every single American."
Now, the promise is fading.
The White House showed a white flag last weekend, discarding its commitment to a "public option" that would compete with private health insurance. Since then, despite efforts to backtrack, the signal keeps flashing: Obama won't go to the mat for a public option after all.
Foes are elated. But it didn't have to be this way.
When President Lyndon Johnson called for a new government program to guarantee health care for the elderly, a fierce outcry against "socialized medicine" echoed from coast to coast. But Johnson was able to sign Medicare into law in 1965 - after he refused to waver.
Now, the president is wavering. And no spoonfuls of rhetorical sugar will help this bitter medicine go down.
At its best, "the public option" was no great shakes. Under the plan, private insurance companies would continue to dominate health care while extracting huge profits. Yet some hoped that the public option might open the door to truly universal health care across the country.
But last weekend, President Obama dubbed the public option "just one sliver" of potential health-care reform. The next day, Health and Human Services Secretary Kathleen Sebelius declared that the public option is "not the essential element."
The retreat jarred activists who've been working hard for meaningful health-care reform. Within hours of Sebelius' statement, the Marin chapter of Democracy For America sent out an "emergency action" alert.
For the organization, which has been very supportive of Obama, the tone of its sample letter to the president was unprecedented: "We insist that you follow through on your pledges and stand up for a strong public option! This is our moment of truth - will we have elected a president who will lead, who will not cave under pressure, who will stand up for the best values of our country?"
On a similar note, days earlier, Marin's Congresswoman Lynn Woolsey wrote in this newspaper: "Congress must act now with reform legislation that provides competition to the insurance companies with a robust public plan that guarantees that everyone has access to high-quality care, regardless of income, employment, or pre-existing conditions."
Unless the final legislation includes such a provision, she added, "it will not get my vote." That's an entirely appropriate stance - based on a clear-eyed understanding of current health-care realities.
Every day, close to home, the status quo is tragic. In the 6th Congressional District, which includes all of Marin and most of Sonoma County, 79,000 people under age 65 - one out of seven - have no health insurance.
Meanwhile, those of us with health coverage - on paper - are apt to discover gaping holes in our insurance when we need it most. That's the profit-driven system of health care.
Even a "robust" public option would fall far short of guaranteeing health care for all. As a matter of principle as well as practicality, the ideal of securing health care as a human right will require a single-payer system, also known as Medicare for all.
During his presidential campaign, Barack Obama made a statement that became a kind of logo on his literature and Web site: "I'm asking you to believe. Not just in my ability to bring about change in Washington. ... I'm asking you to believe in yours."
Our deepest belief should not be devoted to any leader. What's crucial is that we speak up and participate in a democratic process.
Originally published in the Marin Independent Journal. Reprinted with the author's permission.