With the opposition angry, growing, and getting ever-more extreme, with the polls tanking, with its own supporters disillusioned and confused, and with the Republicans smelling blood, President Barack Obama's administration appears to have abandoned hope of bipartisan compromise in health-care reform.
"The Republican leadership has made a strategic decision that defeating President Obama's health care proposal is more important for their political goals than solving the health insurance problems that Americans face every day," Rahm Emanuel, White House chief of staff, told The New York Times.
The Democrats now say they will try to push health care through on their own, using their majorities in the House and Senate, if the Republicans won't join them.
This is a sign of how much trouble the Obama administration is in. Those majorities could crumble, thanks to divisions within the Democrats' own ranks between liberals and Blue-Dog conservatives.
Right wing groups and the Republican Party have mobilized a large, vocal movement whose members' protests at rallies and town halls have successfully hijacked the health-care narrative.
Democratic health care reform has become, for many Americans, not an attempt to improve coverage and reduce costs. Instead, many now see it as a government takeover of private insurance that will lead to state-sanctioned euthanasia of the elderly and infirm.
An NBC News poll released Wednesday revealed that 45 per cent of Americans believed that, under the Democrats' plan, so-called "death panels" would decide when to terminate treatment. In the poll, 42 per cent opposed the Democrats' plan, while only 36 per cent favoured it.
While Mr. Obama's formidable political machine successfully mobilized millions of people to come out to vote for him, it has failed to generate support on behalf of health-care reform.
Political analyst Charlie Cook, author of the much-read Cook Political Report, believes that the administration has left its base disenchanted with its pragmatic approach to a public health-care option, and has failed to recognize the urgency of mobilizing that base in defence of its legislation. "There's always a little complacency, when the 'in' party is self-satisfied and 'out' party is hungry and wants to get back in," he observed in an interview.
As well, he says, human nature being what it is, it is easier to excite voters based on anger and fear than on hope.
Charles Cushman, director of research at George Washington University's Institute for Politics, Democracy and the Internet, agrees.
He maintains that the President made a "huge mistake" by letting Congress take control of crafting the health-care legislation, without mobilizing his own political base to pressure Congress to act.
Prof. Cushman believes that the White House has only recently awakened to the enormity of this mistake and begun to respond. "You're starting to see less coverage of angry right-wingers at these events because the angry right-wingers are starting to be shouted down by angry left-wingers," he observed. "It took them a week to get back in the game."
The turning point might have come over the weekend, when Mr. Obama and his Health Secretary, Kathleen Sibelius, indicated that they might be willing to drop their proposal for a public provider to compete with private insurers, relying instead on non-profit co-operatives to drive down costs. Not only did this enrage liberal Democrats, but Republicans and conservative commentators rejected the co-op proposal.
"The White House has started to realize that there are no Republicans in Washington acting in good faith," Prof. Cushman said. "They want to kill [health reform]because they know if they kill this they kill the presidency."
Instead, the White House and congressional leadership will focus on preparing a final bill that seeks to reconcile conservative Democrats, who are suspicious of imposing a public provider on the health insurance industry, and liberal Democrats, who insist on it.
One worrying aspect of the political polarization surrounding this administration's policies is a dramatic increase in the number of extreme right wing organizations, including the sorts of civilian militias that were a fixture of the 1990s, but that had dwindled in recent years.
The Southern Poverty Law Center, which tracks extremist groups across the United States, reports a marked increase in the number and activities of civilian militias, accompanied by a sharp increase in gun sales, reflecting earlier concerns voiced by the Department of Homeland Security.
One particularly disturbing innovation among conservative activists is for protesters to show up at rallies where Mr. Obama is speaking carrying pistols and rifles. The guns are legal and they pose no threat to the President … but still.
Militias and other fringe groups tend to ebb and flow with the arrival or departure of Democratic administrations. Heidi Beirich, research director at the Southern Poverty Law Center, observes that the election of an African-American president has further fuelled their anger.
"Because Obama is an African-American, there's a racialized aspect to this movement that didn't exist in the 1990s," she said. Hence the birthers movement, which maintains Mr. Obama was not born in the United States and therefore has no legal right to be president.
"It's hard to dismiss that as not a race thing," Ms. Beirich said.
She sees the right as existing on a continuum of radicalization, from listening to shock commentators such as Rush Limbaugh and Glenn Beck, to attending "teabag" tax protests, to shouting down a congressman at a town hall, to joining extremist groups.
"The anger that we're seeing at the town hall meetings is the same kind of rage that the militias and others are tapping into," Ms. Beirich believes.
A peculiar feature of the American dialectic is that those on the lunatic left, such as the types who believe the Bush administration staged the attacks of Sept. 11, are relegated to the fringes of cyberspace while those on the lunatic right get their own talk shows.
That's because, according to Prof. Cushman, the United States remains a conservative country, with the political centre actually on the centre-right. "That allows a far larger chunk of the crazy part of the right wing to be accepted as part of the dialogue," he said. "Where with the crazy left, everyone says 'oh, aren't you silly' and ignores them, the crazy right-wingers have a seat at the table."
In just under a month, Congress returns, and the August follies will be replaced by serious wrangling as the administration, along with the leadership in the House and Senate, struggle to craft legislation and corral votes.
In the meantime, not all the town halls are going the protesters' way. When Barney Frank, the irrepressible chairman of the House financial services committee, was confronted by a protester, he asked her: "On what planet do you spend most of your time?" and told her that "trying to have a conversation with you would be like trying to argue with a dining room table."
Then he asked the crowd: "Which one of you wants to yell next?"
If they had a few more Barney Franks, the Democrats might actually be on top of this debate.