Was it worth it?" His theory is that the present election is a "backlash" against healthcare reform and... well, he doesn't mention anything else, but presumably he believes that there is also a backlash against the Obama Administration's continuation of Bush-era bailout policy toward the financial and auto industries, and the economic stimulus bill. But let's be honest for a moment. The key issue is the economy, and the only thing that the Democrats could have done to better the economy would have been to gamble on a larger stimulus bill. The auto industry bailout actually worked. The financial industry bailout was lemon capitalism at its worst, so people have every right to be disgusted, but it was bipartisan lemon capitalism - pretty much all of our nation's legislators were on board. Vote the bums out - all of them... er, where was I going with this again?
History already informed us that the Democrats were going to lose seats in this election, even before we talk about the terrible state of the economy. Or the fact that a lot of Dems were vulnerable because they held seats in Republican districts, having won elections when voters were punishing the Republicans a whopping two to four years ago. Although Douthat singles out healthcare reform, why should I believe that the Dems would have retained control of the House had they not pushed that legislation through? And if you are imagining a world in which the Obama Administration had let GM, Chrysler and AIG fold, and had pulled all support from the financial industry... let's just say, our present economic problems would be enviable.
So President Obama is in pretty much the same situation he would have been in had the Democrats pursued a minimalist agenda. He may have lost a few more seats, and there may be a few more... should I say "eccentric"... Republican Senators than might otherwise have been elected, but a smaller Republican majority in the House is still a Republican majority.
Here's another thing to consider: Had the Democrats been timid in their legislative agenda and still lost seats, every indication is that they would become even more timid. Had they lost the House, as was almost certain to occur due to the economy, they wouldn't have been able to push through any significant reform. So the reward for not pushing a modest, pro-corporate, largely status quo sustaining "reform" bill would have been losing the ability even to do that. Wow.
It also seems fair to ask, if your party believes an issue is extremely important, but you think there might be a significant backlash should you enact legislation addressing that issue, should you do nothing? Is the G.W. Bush model on Social Security reform the one Douthat sees as "working", leaving aside for the moment the fact that the Republican Party was hammered in two consecutive elections despite dropping the issue? Is Douthat arguing for what often appears to be the status quo - nobody will address the nation's most pressing issues until they reach a crisis point for fear of having to take responsibility for their actions?