By Evan Falchuk

The perpetual anxiety machine called Health Care Reform keeps spinning.  Yesterday, it was President Obama’s turn to give it a push, on Fox News.

The interview is getting attention for its testy exchanges, but I thought the President did just fine.

What surprised me was how unaware he seems to be, like other politicians, of how their words stoke anxiety over their reform plans.

Here’s what I mean.  The President was in command of the reasons why he wants reform.  His trouble is that the legislation he supports is so big and complex, he doesn’t have a simple way to explain it.  In the course of a 15 minute interview, he talked about costs, small business, insurance pooling arrangements, good subsidies and bad ones, pre-existing conditions, Hawaiian earthquakes (?) and other natural catastrophes, health care quality, federal burdens on state governments, insurance companies, the federal deficit, “doughnut holes,” Medicare, and “1/6th of the economy that is a huge drag on the economy.”

It’s exhausting .  And unless you’re a policy wonk, your impression of all this is that there is a huge plan that no one really understands, but about which one thing is clear: it’s going to affect me in ways I’m not going to like.  It doesn’t help when the President says things that, you know, confirm that:

There are definitely people who are worried that maybe these changes are in some fashion going to affect them adversely, and I think those are legitimate concerns – on the substance.  Then, someone who votes for this bill is going to be judged at the polls for it, and the same is going to be true if they vote against it. . . . The core of this bill is going to be affecting every American family.

If you’re trying to quell anxiety, this is a strange way to do it.  Which suggests he’s not trying to do that.  He just doesn’t get the deep anxiety people feel when they think their health benefits are going to be changed.

You know what’s worse?  All that anxiety is probably unnecessary.

Why?  Because if you’re one of the tens of millions of Americans who get their coverage through a large, self-insured employer, reform probably isn’t going to affect you much.  If you are one of the tens of millions of Americans who live in states that already have the kinds of “insurance market reforms” in the legislation, your life will be no different.  If you’re one of the millions of people who get their coverage from a government employer, your benefits will be unchanged.

What will change is that at some point in the future, some people without insurance will be able (or required) to buy some kind of coverage through some kind of national “exchange” with some kind of very expensive federal subsidy.  And that people who live in states that have decided against having certain rules in their health insurance markets will now have them.

Sure, there’s lots and lots of other stuff in there, but this is the guts of it.  Some of it is good, some bad.  But does this sound like what Nancy Pelosi calls the “the most important initiative most of us in Congress. . .will ever do in our legislative lifetimes”?  Does it sound like what many Republicans call a “government takeover” of health care?  Of course not.  Which is why the political journey of health care reform has been so strange, so confusing, and so distressing to the public.

So, the President is right when he says that the cost of health care is too high, and that the government can do more to help.  But the trouble caused by the way reformers have handled this is going to take a long time to go away, even if the current plan becomes law.  Even some of the President’s top supporters, like Missouri Senator Claire McCaskill, think so:

He’s got so much to lose by continuing to push for something that’s not going to be immediately popular. It’s not going to be popular by November; it’s not going to be popular by November of 2012. It’ll be popular 10 years from now.

And so it ends, with a health-care vote expected this weekend. I wonder at what point the administration will realize it wasn’t worth it—worth the discord, worth the diminution in popularity and prestige, worth the deepening of the great divide. What has been lost is so vivid, what has been gained so amorphous, blurry and likely illusory.