In eyeball-to-eyeball confrontation, the President blinks by telling governors he will let states opt out of the individual mandate for medical insurance in 2014, three years earlier than the reform law allows.
After a waste of two months with a House dog-and-pony show of repeal and Senate failure to go along, the bipartisan mess that politicians have made of American health care is now a post-disaster triage scene after last November's electoral catastrophe.
As the Obama White House starts to back off, Republicans refuse to take "yes" for an answer. Sen. Orrin Hatch, who eulogized Ted Kennedy as "a United States senator who was dedicated to the last to advancing the vision of America that he held so dearly," is now fighting what Kennedy called the cause of his life with near-apoplectic fervor, denouncing Obamacare and calling the President's new concession "bullcorn" on PBS.
Hatch is up for reelection next year and can feel the hot breath of the Tea Party, which blew away his Utah colleague Bob Bennett after 18 years together in the Senate.
In this atmosphere, the battle will only grow more bitter and worsen a literal life-and-death struggle with political posturing while health care deteriorates.
In the real world, insurance companies still siphon off one of every three dollars that should be spent on patient care and tie up doctors, hospitals and labs with claim-prevention paperwork.
Providers struggle to find innovative ways to make patient care better but are overwhelmed by the insanity of the system.
One of the best doctors I know is forced to cut back his practice severely by converting to Concierge Care, in effect charging patients a hefty annual fee to keep qualifying for his services.
Even before the new law's reforms take full effect, the old system is collapsing. We don't have death panels yet, but rationing is well on its way, with Washington blowhards on both sides beating up on one another as patients sit unattended in waiting rooms.
Update: A New York Times editorial challenges Republicans to match the President's willingness to change with ideas of their own:
"Alternative approaches might include replacing the mandate to buy insurance with a system to automatically enroll people in health plans, reformulating tax credits for small businesses and low-income individuals to encourage near-universal coverage, adopting such liberal approaches as a single-payer plan or a public option, and even moving all or part of the enrollees in Medicaid into new health insurance exchanges. These would all have to be done without driving up the federal deficit or reducing benefits, affordability and coverage."
Waiting for a response from Dr. Boehner or Dr. McConnell, they should not hold their breath.