Like much of the "says one thing, does another" reporting these days, this piece is a little bit naive. Can you believe that about the NYT? Here's why I say so: Health-care reform was a central issue in the Obama campaign. If the candidate was sincere, of course he will, as president, take an active interest in how the legislation is shaped. His public stance of letting Congress work out the details is only realistic, because at this point, that's where the necessary votes are. The writer isn't very sophisticated about how negotiations take place. Obama's interest is in improving the current situation, not in holding out for every desirable goal and possibly never achieving anything. Didn't another recent White House make that error, on the same set of issues? Finally, the president needs to publicly call for A, B, C, and D, however painful they may be to the medical industry, to remind them of the cost of their failure to cooperate in bringing about two or three of the four goals. Forgive the cliche, but it's usually true in politics that half a loaf is better than none.