Opponents of health care reform have made a hilarious about-face in the past year. In 12 months they’ve managed to reposition themselves from vanguards of “the best system of care in the world,” to a noticeably more demure standing, complete with blanket admissions of a “broken system” along with conciliatory promises to fix it.

It isn’t an inconsistency without meaning. Rather, it’s an industry standard, similar to corporate polluters’ decades-long history with the green movement. First, throw money at lobbyists to keep laws profitable for business, astroturf public opinion while portraying the opposition as liberal, hippy freaks for extra effect. When resistance becomes futile, develop green-wash ad campaigns and form bogus global initiatives in an attempt to appear amenable to progress. Wash, wear, repeat.

With an annual price tag of about $2.5 trillion, U.S. health care now comprises 16% of our GDP. Health insurance premiums have doubled since 2000, and health care costs have risen faster than the rate of inflation. Medical bills are now behind only job loss as the primary cause for personal bankruptcy. Due to rising costs, nearly half of small businesses now provide employee health insurance from what they did just 16 years ago. The uninsured in the U.S. now total more than 45 million people, or 15% of the population. A new Harvard study published in the American Journal of Public Health shows that 45,000 Americans die every year because of a lack of health insurance. Life expectancy in the U.S. is now projected at 38th in the world, right behind Cuba. We do, incidentally, offer some of the shortest waiting lists to be seen by a medical specialist. Captain Obvious’ quick capsule conclusion: the U.S. health industry is designed by the rich, for the rich.

Don’t believe me? Lobbying fees from the pharmaceutical and health sector have so far totaled more than $134 million in 2009. Of these figures, the top five U.S. pharmaceutical companies accounted for about $40 million of it: Pfizer has so far given nearly $19 million to more than a dozen lobbying groups in 2009 alone, with at least three contracts totaling more than $5 million each. Johnson & Johnson spent about $4 million in lobbying in 2009, Merck & Co. has given more than $3.7 million to lobbyists in 2009 and Eli Lilly and Company has given nearly $8.3 million to lobbying groups in 2009. Then there’s the nation’s insurance giants: Blue Cross and Blue Shield Association has given almost $6.7 million to nearly 20 different lobby firms so far in 2009, UnitedHealth Group Incorporated has given more than $4 million this year, CIGNA Corporation has given over $2 million, WellPoint, Inc. has given nearly $2.6 million and Aetna Inc. has given a total of nearly $1.8 million. Even the American Medical Association, the largest association of physicians in the U.S., gave about $10 million to lobbyists in 2009. AMA has given lobbyists more than $208 million over the past 10 years, and is ranked as the second-top lobbying spender in the nation, behind only the Chamber of Commerce. And they want to tell us that rising costs are the results of litigation insurance?

According to a number of recent surveys, most Americans (and U.S. physicians) support a health care reform package that includes a public option. And why wouldn’t we? We already have a number of ‘public’ healthcare options available in this country: Medicare, Medicaid, the Children’s Health Insurance Fund, as well as numerous programs for veterans and employees in the public sector. The fact is, public services have been a long-standing component in the American system. I’ve still never heard bookstore owners complain about the competition they receive from public libraries. The fact is, public services have been a long-standing tradition for the American people.

No thanks to the health care lobby, the current debate has been rife with Capitol Hill histrionics and ersatz revisions of “Not in my Backyard” theater, featuring a Potemkin village of citizens riled by frothing radio and TV personalities who contribute little more than verbal diarrhea to an otherwise invaluable conversation. By disseminating half-truths and reinventing town hall meetings as performance art installments of “Hee Haw,” the battle plan becomes clear: throw as many wrenches into the machine as possible and see what catches, whoever screams “socialist!” the loudest wins. Two words and suddenly Joe Wilson is a household name.

Not that the Obama plan isn’t an easy target. For all its strong points, the Obama administration has done a crummy job of breaking down the specifics into a digestible, easy-to-understand platform for the American public to rally behind. As such, the plan has become a hotbed for half-truths and a potential victim for revisions of the “Harry and Louise” TV spots that sank Clinton’s reform hopes in ’93. Some quality criticism would be welcome. Personally, I have a hard time believing Obama’s plan can be feasibly funded by capital gathered from reforms or fees from insurance giants and large companies that don’t offer employee insurance. Moreover, taxing providers of high-end insurance plans could just influence them to parse down their benefits until they fall into a tax-less bracket. Finally, bringing 45 million into the land of the insured will undoubtedly have an effect on the current network of insurers, not to mention doctors and hospital staff. It’s a growing pain I’m willing to take, but Obama hasn’t clearly explained how he will mitigate this shock to the system.

According to the Institute of Medicine of the National Academy of Sciences, we’re the only wealthy, industrialized nation that doesn’t offer health insurance for its citizens. The crux of the health care debate, no matter what side you’re on, is predicated on the principle of whether you believe there is a fundamental right to health care. That is, your support or opposition to the position that everyone has an equal right to care automatically determines whose side you’re on at the present moment, lest you be swayed by nothing short of an ethical epiphany. And it’s for this divisive reason that the public option may be rendered a pipe dream. History threatens to repeat itself, and given the magnitude of what’s being proposed, we should both know better and yet expect nothing less.