Today here instead is a discussion and presentation particularly for non-American readers (if anyone still reads this at all) of the political debate as it rages inside the USA. The main point here: it is not particularly explicitly a conventional ideological debate, despite overtones of one or the presence of it among political activists. Perhaps the debate can be said to have cultural ideological roots, but at its real core it is not about the more political-economic issues that those with stereotyped views of Americans might think.

The fact is -- the real resistance is coming not primarily from some rigid political or even cultural ideological phobia to "socialized medicine" or "big government" per se, but from a simpler sense that whatever is coming down the Obama pike will mean that a person, particularly an old person, will not get to choose their own planned health program. Nor is the opposition some weird phobic reaction to a black president, or some other oddball explanations offered by people who cannot understand that many other people just don't want their familiar planned personal private essential system of health played with by politicians.

The real political debate boils down to fundamentally two fighting sensibilities that, ironically, are not inherently exclusive, at least conceptually:

1) No one should die or seriously suffer because they cannot afford health care, versus

2) I want to individually choose and control my own health care program. (Translation: I choose my doctor and hospital and drugs and caregivers, not a "bureaucrat".)

The truth is that #1 is embraced by most Americans. Indeed, the long-standing existence of, and loyalty towards, American public education illustrates that Americans don't mind government paying for and running essential services. It's even expected. We have public utilities for water and electricity and yes, some public hospitals, as well as national parks and all kinds of services.

But #2 is also true. The fear of bureaucrats and limited choices is also at the root of anti-private insurance company sentiment. But if you've watched too much Michael Moore, you would not know that most Americans, while unhappy about medical costs and insurance bureaucrats, and also ready to think about large changes, still are generally ">not dissatisfied about their personal system of health care. The Great Uninsured Masses we hear of are often young people who do not care to be insured.

The people who vote the most and who use health care the most are the elderly, and alot of them prefer their current state to an uncertain one. They are the resistant ones. Even the Lobby of Lobbies (no it's not the Israel lobby, but the Old Folks lobby, the AARP), which supports some kind of change, has been getting guff and resignations from their own members for doing so.

Again, it comes back to the feeling of control. Most Americans do not care who brings them essential electricity or water as it is a generic thing. Education is a bit different though at early phases most education is generic and is preferred to be. But if you don't like it, you can pull your kid from the public school system and send him or her elsewhere. The fear is that Obamacare will not allow one to individually choose the doctor or treatment or drug regimen, or be able to afford it by gutting Medicare.

There may be a cultural element to all that. Americans don't mind at all the government subsidizing their choices (Medicare or Medicaid, etc), or regulating the basics of necessities, or even offering a free or government-run public alternative (remember, folks, there are public health hospitals and facilities all over the United States). But the idea of choice, or the illusion of it, needs to be preserved. The "death panel" noise struck a nerve because it directly addressed the fear that government was going to give some people no choice but to die. A distortion, true -- but one that resonated not because people fear government-inflicted genocide of the elderly, but fear the consequences of choice being removed.

If Obama can create or preserve the fact or image of retained individual choice in his plan, he wins.

If not, he loses, like Hillarycare did in the 1990s.