The Democrats were doomed as soon as it became clear to the American people that their goal in healthcare was to save money. And here, all along, the American people thought that their government had wanted them to live longer and better lives, not shorter and cheaper lives. The hapless and luckless Martha Coakley was simply the first Democratic to come before the voters since the deeply and grimly utilitarian calculus of the Democrats became blindingly obvious to the American people.
According to the Democratic orthodoxy of the last few years, "House" and Marcus Welby and the Hippocratic Oath go out the window, replaced by a cost-benefit analysis conducted by CBO, OMB--or perhaps a "death panel." But budgets aside, the true medical ethos is to do more, not less. Some in the Obama administration might wish to change that ethos--and have written of their desire to say change it--but the folks never signed on to that. And so saying that the American people are expendable, less worthy of spending than another bailout tranche for AIG or more money for Afghanistan or the mayor of Baltimore, was never going to fly.
That the government will do less, deliberately, to keep people alive was simply an affront--even if the Democrats claimed it was part of some egalitarian scheme, (But of course, any egalitarian premise was punctured by the palpable reality that the rich and the connected will still get more, not less.) Such cynical brokering of human lives on the slab of Kennedy School-ish public policy is a "taboo trade-off" in the minds of Americans. Democrats should have known better than to violate such a powerful taboo.
The term "taboo trade-off" was coined in the early 90s by academics Alan Fiske and Philip Tetlock; it refers to an idea which "shocks the conscience," to borrow an evocative phrase from Justice Frankfurter. Fiske and Tetlock defined "taboo trade-off" as "Any explicit mental comparison or social transaction that violates deeply held intuitions about the integrity, even sanctity, of individual-to-individual or individual-to-society relationships and the values that animate those relationships."
Those words pretty much sum up Obamacare as it has come to be regarded by the voters. So goodbye, Martha. Now, who wants to be next?