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I just got off the phone with a well-informed Dutch reporter based in Washington, D.C. His monumental assignment was, in part, to explain to a puzzled Dutch audience how such an important public policy debate as health care for Americans became infected with so much fear, anger and distrust. And why, he asked, do fearmongers have so much power against serious analysts and policy makers? A hard question to answer.

The reporter, from the Dutch paper NRC Handelsblad, initially focused on Consumer Watchdog's report describing how the two top U.S. health insurance conglomerates are pushing employees to lobby Congress--chiefly to kill any voluntary government-run option, like Medicare, to their for-profit model. Do most companies in the U.S. do this, he asked. Not usually to this extreme degree, not to my knowledge, was my lame reply--given that the biggest state, California, bans such behavior. The insurance companies are hell-bent on preserving every penny of revenue, profit and lavish coroporate compensation.

On the larger question, the tactical one, I answered that what he's seeing is the extension of political campaign tactics into the whole sphere of serious public policy. There's no more putting aside the sharpest sabers after the election so important work can get done.

For instance, the "death panels" furor. After it spread on the Internet, serious news organizations gave the weird, fear-mongering accusation credibility by reporting it at least in part as a one side-other side issue. Major politicians, including Sen. Charles Grassley of Iowa, a chief Senate health reform negotiator, pretended to take it seriously and were quoted seriously.

In the Netherlands that kind of behavior is a mystery, because it's a nation of generally more civil politics--financed largely by public rather than corporate contributions. It's also a nation that combines public and private health insurance to provide comprehensive health care--including long-term care--to nearly all its residents. But its private health insurance, tightly regulated to curb premiums, require coverage and prevent gaming of the system, is nothing like our Wild-West, investor-driven health insurance. So the Dutch just don't get why the U.S. health care system remains such a mess.

Neither do I. But expert manipulation of fear, and unprecedented amounts of corporate money injected into Congress, certainly go far in explaining it. Bottom line: when elected officials say in public that they're  interested in killing the Obama presidency--not in achieving a modern health care system that doesn't bankrupt families and government--the goal posts get set way, way far off.