This isn’t about betrayal, or a slap in the face, or an insult. It isn’t about strategies to keep seats, or grand theories of justice. Democrats in Congress have the chance to cast a single vote that will make the lives of tens of millions of Americans less wrenching, our demises less brutal. That’s what this is about.

– MD, an anonymous reader of TPM, making explicit the real world effect of a failure by the Democrats in the House to approve the Senate healthcare reform bill and seek improvements later. Where is the courage on the left to vote for real reform even at the cost of each members re-election?