Matt Taibbi has a characteristically scathing post on the Obama administration’s deal with PhRMA, which basically entailed buying the lobbying group’s tepid support by refusing to let Medicare bargain drug prices in bulk and by banning re-importation of drugs. This is all mostly true, although I think it misses the important point that Republican lock-step obstructionism and general intransigence among conservative Democratic Senators has left the administration between a rock and a hard place. If Republicans are almost entirely unwilling to negotiate and key Democratic legislators basically in hock to health care interests, it’s hard to see how see how health remains politically feasible without the support of affected industry groups. If you think the timbre of August was bad, imagine what it would have looked like with drug makers, hospitals, and device manufacturers dumping rocket fuel on the fire. Even if you assume an almost unprecedented — and perhaps ultimately misguided — dose of legislative courage from the left, I still don’t think you can get to 60 without providing cover for the conservative wing of the Democratic party.