MAJORITY RULE…. The New York Times has a good editorial on the debate over health care policy today, which offers a compelling overview of the lay of the land — where we are now. Long story short, reform efforts can’t garner bipartisan support, largely because GOP lawmakers have become craven. Reform efforts can’t overcome Republican obstructionism, because the Democratic caucus has “only” 59 members, and some of the 59 are both antsy and panicky.

That leaves the governing party in a bind, and makes the significance of “reconciliation” paramount.

Reconciliation bills are primarily intended to deal with budget items that affect the deficit, not with substantive legislation like health care reform. Senators could challenge as “extraneous” any provisions that do not change spending or revenues over the next five years, or would have a budget impact that is “merely incidental” to some broader policy purpose, or would increase the deficit in Year 6 and beyond.

So how much of the proposed health care reforms could plausibly fit into a reconciliation bill? The answer seems to be: quite a lot, though nobody knows for sure. […]

Nobody knows how the Senate parliamentarian, an obscure official who advises the presiding officer, would rule on any of these complicated issues. But if he were to take a narrow view and eliminate important features, it could leave the reform package riddled with holes — perhaps providing subsidies to buy insurance on exchanges that do not exist, for example. Thus there are plans afoot to use a second bill to pass whatever reforms will not fit under the rubric of reconciliation, but those would be subject to filibuster and would have to depend on their general popularity (insurance reforms are enormously popular) to win 60 votes for passage. […]

Clearly the reconciliation approach is a risky and less desirable way to enact comprehensive health care reforms. The only worse approach would be to retreat to modest gestures in an effort to win Republican acquiescence. It is barely possible that the Senate Finance Committee might pull off a miracle and devise a comprehensive solution that could win broad support, or get one or more Republicans to vote to break a filibuster. If not, the Democrats need to push for as much reform as possible through majority vote.

A spokesperson for Senate Majority Leader Harry Reid (D-Nev.) said two weeks ago that Reid is prepared to pass health care reform “by any legislative means necessary.” Forcing the Senate to give a bill and up-or-down vote — majority rule — would certainly fall under this umbrella.

I can appreciate the fact that the reconciliation process was not intended to be used this way. But whenever that point comes up, my response is always the same: the filibuster rule was not intended to be used this way, either. The idea that a bill that enjoys majority support in the House and majority support in the Senate is not allowed to pass is fundamentally at odds with the American political process, and yet, it’s quietly become both accepted and routine.

Health care reform deserves a vote. If most senators oppose it, the bill will fail. If most senators support it, the bill should advance. If the only way to make that happen is reconciliation, so be it.

Steve Benen

Follow Steve on Twitter @stevebenen. Steve Benen is a producer at MSNBC's The Rachel Maddow Show. He was the principal contributor to the Washington Monthly's Political Animal blog from August 2008 until January 2012.