THE ACCOMPLISHMENT-FREE ALTERNATE UNIVERSE…. In the wake of the 1994 midterms, it was not uncommon for many — in the Democratic Party, in the media, in the country in general — to wonder whether the results would have been different had the health care reform effort not failed. Maybe, the thinking went at the time, if Dems could have pointed to a milestone accomplishment, and hadn’t suffered such a legislative fiasco, they wouldn’t have lost the House and Senate.

Sixteen years later, a “war” is beginning to break out in some Democratic circles with a similar question: maybe if Dems didn’t achieve this milestone accomplishment, they wouldn’t be poised to endure drastic losses in the midterm elections.

Obviously, it’s a speculative issue, and no one can say with confidence what public attitudes would be like now if (a) health care reform had failed; or (b) Democrats never even tried to get it done. The economy is, was, and will be the top issue on voters’ minds, and right now, it’s just not good enough to help the incumbent majority withstand the prevailing/historical winds.

But that won’t stop the debate. Jonathan Cohn imagines an alternate universe in which Democrats failed to deliver on health care reform and President Obama dropped the issue. It’s well worth reading.

Of course, the second-guessers could be wrong. Imagine for a second that the future had turned out differently — that, after passing the stimulus, Obama turned to health care reform and made it the centerpiece of his domestic agenda. Maybe the fight would have turned into a fourteen-month-long political boondoggle, helping to turn independents against Washington and allowing conservatives to rally. Maybe the final bill would have included major compromises, leaving the liberal base dispirited. And maybe, after it was all done, Democrats would be likely to lose the House and in danger of surrendering the Senate — with losses even more severe than the ones they face now.

It’s possible — just as it’s possible that the outcome of this election actually has very little to do with health care. It could have been determined back in February, 2009, when Obama and his allies settled on a too-small stimulus — whether out of political necessity or economic misjudgment — while standing behind necessary but unpopular rescues of the banking and auto industries. The truth about these counterfactuals is that you can never really know what might have been if history had unfolded differently.

One thing is certain, however. Had Obama succeeded in passing health care reform, he would have brought financial security and access to basic care to millions of Americans, while beginning the hard and necessary work of reengineering the health system to make it more efficient. Yeah, the voters might still be really angry. The Democrats might still be on the verge of a historic defeat. But the country would be a lot better off.

This is, of course, a description of imaginary circumstances, but the point should be obvious.

Similarly, Matt Yglesias’ take yesterday was very compelling: “[O]bviously you don’t want to risk a congressional majority over something trivial. But the Affordable Care Act is not a trivial law. It’s one of the most important laws of the past 30 years. So then the question becomes, was it important in a good way? I think it was. And that’s the job of a congressional majority — to pass important bills that change the world for the better. I think the 111th Congress did a fair amount of that.”

This is, I’ve long assumed, why people seek to serve the public through elected office in the first place.

The alternative, by the way, is leaving a dysfunctional health care system in place for the indefinite future — bankrupting families, businesses, and government agencies. As Greg Sargent noted today, “Those who think Dems shouldn’t have tried reform this time around need to be asked when Dems would have gotten their next bite at the health care apple — particularly with such big majorities.”

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.