The first thing you need to understand about healthcare reform is what Jane Hamsher identified long ago: nothing--absolutely nothing--is going to trump the White House's deal with PhRMA and the insurance industry. The question you need to ask yourselves is: why? If you're intellectually mature enough to get past "personal betrayal" as your best answer, you'll be on the right track.

While you ponder that one, you might want to also consider why nothing has been done--nor will anything serious actually be done--about financial industry reform. Standing up to the financial industry in the current political environment should be a no-brainer. So what in the heck is going on here? If you can think past shadowy conspiracy theories and possible personal enrichment for the Obama family, you'll be doing the kind of thinking that will help actually solve the problem.

The problem is people like me, and the people I work for. I'm what they call a Qualitative Research Consultant, or QRC for short. Here's my website. There's even a whole association of us who meet regularly to discuss ideas and tactics. Together with the AAPC, the MRA, the AMA, ESOMAR, and a whole host of other organizations you've never heard of, we have more power and control than you know. We're extremely good at what we do, and we do it all behind the scenes, appealing to and manipulating your subconscious brain in ways that your conscious brain has little to no control over.

Give us a little money to test some things out, and we can work magic. Our business is persuasion, and we're very good at it. Just watch PBS Frontline's series, The Persuaders to get just a small inkling of what you're up against. We can make a company that earns a 38% gross profit margin manufacturing purely propriety products seem hip, cool and progressive. We can take sugar water and sell it back to you as a health drink, and even Whole Foods shoppers will believe it. We can take 30 different brands of vodka with almost exactly the same ingredients, and make you understand instantly just what kind of person drinks which brand, and how much you should expect to pay for each, without a moment's thought. For any given category of products, I can show you a bunch of different brands, and you'll be able to tell me a wealth of information about each one, despite the near absolute similarity of their actual products to one another. One exercise we QRC's like to conduct involves actually turning a brand into a person in a group discussion; it's called personification. And you wouldn't believe how effectively and universally we can tailor a brand's image, right down to what kind of car that "person" would drive, and what music he/she would listen to. So much attention has been paid to Naomi Klein's outstanding Shock Doctrine, that few pay much attention anymore to her far more provocative and important work No Logo. If all Americans truly internalized the message of No Logo, people like me would be out of work, and we could really reform this country.

For a little coin, we can even make poor people hate inheritance taxes, just by using a few little words that work. The biggest difference between Obama and FDR/LBJ is that people like me weren't really around back then. As the TV show Mad Men can show you, our industry was just getting off the ground in the mid-1960's. And while it's true that the Democratic ad consultants of the 1980's and 1990's and early Aughts were wildly ineffective, that says far more about the prevailing consultant class in the Democratic Party than about the power of ad consulting in general.

So here's what you have to understand. If the health insurance and financial industries really felt scared by any particular politician or political party, or their lobbying efforts were inadequate, they could throw them out of power in a heartbeat. With a wave of their hand and a few billion dollars or so in our direction, the pharma companies and Goldman Sachs could absolutely destroy the Democratic Party in 2010 and beyond. The only reason they don't do so is that it's cheaper and easier to buy a few key Democrats off instead, and intimidate the rest. Plus, they don't have to run the risk of a right-wing populist backlash, either.

That's why Barack Obama can't renege on his deal with PhRMA: PhRMA almost singlehandedly destroyed Hillarycare in 1993, and spent the money to tip the balance of the elections in 1994. They can easily do it again. So could Goldman Sachs and the rest of the financial vampires. Rahm Emmanuel knows this, too: the deals are in place in return for their holding their fire.

And each and every one of you is being taken for fools. You work for an election or two to put chosen leaders in place, and expect those leaders to work their "leadership" magic to ram reforms down the throats of the corporate sector, failing to understand just how fully the corporate sector holds the cards. It's not the campaign contributions: it's the persuasion money.

You're looking for a savior. And like that Savior of biblical fame, s/he isn't coming, as long as there are people like me out there. I personally won't work for a company or organization that goes against my personal convictions. But 99% of us certainly will.

If you want to win, you will ORGANIZE. You will organize in the same way the Right has done for the last 40 years, and you will spend money on persuasion, where it really matters. You will, in short, make the politicians as afraid of you as they are of them. The Right has built vast networks of think tanks, newspapers, periodicals, cable news channels, and political advocacy organizations to spread their finely tuned, well-honed messages. Their politicians may fail them, and their actual policies may be deeply unpopular, but their message machine nearly always works its magic to get them what they want, even when Democrats are in power.

That's partly because the American political Right never quits and never gives up. They know that organization is the key to their success, and they don't trust politicians to do their work for them. Democrats, on the other hand, get disappointed and quit when our politicians don't pan out the way we wanted. That's why we lose.

As the healthcare debacle went on month after month, I didn't ask myself why the Democratic politicians weren't pushing single-payer or Medicare for all. I wanted to know where the Left-leaning organizations were. Where were the think tanks, the message machine, the newspapers, the whole infrastructure? Where were the national, well-tested ad campaigns pushing Medicare for All? Where were the free screenings of Sicko at major movie theaters across the nation, complete with sponsored food & drink for those who attended and signed up to take action? Where were the mid-cycle ads done by Madison Avenue professionals targeting specific Senators and making them deeply uncomfortable? Where, in effect, was the message campaign?

It didn't exist. What we had were labor unions and the AARP delivering generic hopeful messages without an ounce of the power or creativity that one might find in a random Budweiser ad.

If you want to win, ORGANIZE. Develop parallel organizations willing to persuade with the power and intensity of a corporation. As long as people like me are out there, and most of them are willing to work for the highest bidder, you'll need to stop looking for saviors, and instead learn to fight fire with fire.

The upcoming battles won't wait for us, and there won't be anyone coming to save us but ourselves.