The president got creamed in Massachusetts. No amount of blaming this disastrous outcome on the weaknesses of the local Democratic candidate or her Republican opponent’s strengths can gainsay that fact. Obama’s opportunistic search for win-win solutions to our health care concerns and our larger economic problems is leading to a lose-lose outcome for the president and the country.

The two issues that mattered on Election Day were the economy, which Obama has sold out to Wall Street — as quite a few disgruntled voters pointed out — and his plea to save health care reform, which the voters who had backed him for the presidency with a huge majority now spurned. It is significant that it was the voters of Massachusetts who have now derailed the Democrats’ efforts to revamp the country’s health care system by denying them the necessary 60th vote in the Senate, for these voters know the subject well.

The federal proposal is based on their own state’s model requiring people to obtain health insurance without the state doing anything to effectively control costs through an alternative to the private insurance corporations. Lacking a public option, the cost of health care in Massachusetts, already the highest in the nation at the time of the plan’s implementation, has spiraled upward. Services have been curtailed, and many, particularly younger people, feel they are being forced to sacrifice to pay for a system that doesn’t work.

Instead of blindly following the failed Massachusetts model, Obama should have insisted on an extension of the Medicare program to all who are willing to pay for it. He squandered the opportunity to bring about meaningful health care change that the public would have supported had it been kept simple and just. Instead, Obama gave away the store to medical profiteers. They, in turn, hopelessly muddied the waters with well-funded scare advertising tactics that principled leadership on Obama’s part could have thwarted.

A mere seven months ago, The New York Times/CBS poll found that 72% of Americans “supported a government-administered insurance plan — something like Medicare for those under 65—that would compete for customers with private insurers.” Even half of those identified as Republican said they would back such a public plan, as would three out of four independents and 90% of Democrats. Instead of heeding that call by endorsing a serious extension of Medicare, along with increased subsidies for those who could not afford it, Obama played to the conservatives in Congress — and they rolled him.

If he wasn’t prepared to make a breakthrough in health care, and that meant a reform program that would begin sooner rather than later, he should have put it on a back burner. The furor over a very unsatisfactory plan drew attention from the far bigger crisis concerning the meltdown of the nation’s economy. By accepting and indeed expanding the Bush administration’s strategy of throwing money at Wall Street, Obama ceded the populist label to the Tea Party Republicans who now pretend that a banking mess brought about by their radical deregulatory philosophy is not of their making.

It is the economy, stupid, and the sooner Obama grasps that, the better for his and the nation’s prospects. A new Wall Street Journal/NBC poll finds that “Americans ranked job creation and economic growth as their clear top priority for the federal government, well above national security and deficit reduction. Health care, Mr. Obama’s top domestic priority in 2009, now ranks fourth, closely trailing the deficit and government spending.”

Of course, the public is right. In the midst of the worst economic crisis in 70 years, why waste enormous political capital battling to pass a health care plan that is modeled on a proven failure in Massachusetts, as voters there clearly registered? Meanwhile, the president has dropped the ball in the effort to make bankers act responsibly by forcing them to forego outrageous bonuses and help homeowners stay in their homes.

Again quoting the message of that Wall Street Journal/NBC poll: “The president’s focus on health care amid heightened job concerns could be hurting his ratings. At the one-year mark of his presidency, 35% of Americans said they were ‘quite’ or extremely’ confident he had the right priorities to improve the economy, down from 46% at midyear.” The Journal noted that a majority disapproved of the government’s response to the financial crisis, adding, “The related problem for Mr. Obama is the public’s lingering anger about the bailouts of 2008 and 2009, which helped boost bank profits even as unemployment grew — a toxic political problem.”

To salvage his presidency, Obama must reverse course and make solving the “toxic political problem” of Wall Street greed that’s bankrupting the country his highest priority.