The level of anger about the president’s health care proposal has some scratching their heads trying to understand its genesis. Those who support health care reform may want to dismiss the protests as fake grass-roots opposition run by corporate interests. While money is flowing into the “nay” side of this debate, there is something more at work.

Former Vermont Gov. Howard Dean, who made health care reform a cornerstone of his 2004 presidential bid, has some ideas on the question.

First, he suggests a closer look at the shouting critics at congressional town hall meetings. Most are 65 and older, and therefore rely on Medicare. As with the timid efforts in the past to reform Social Security financing, elected officials dipping their toes into issues affecting seniors should expect a piranhalike response. Gov. Dean, a former physician, writes in The Washington Post that “many of the things that are being said are designed to frighten America’s seniors, a potent voting bloc.”

He also notes that Mr. Obama’s voting base is largely under the age of 40. In a forum on the issue, Gov. Dean said older voters resent the younger generation asserting its political will. The older group is shrinking in number and angry about losing influence, he asserted. Mr. Obama is not the sort of person they ever expected to see in the White House — that is, there may be a latent racist element to some of the anger, he said. And they fear change.

Second, much of the protest is aimed at the plan simply because it was proposed by Democrats. The party regained the White House and a strong control of Congress, and passionate Republicans have seized on an issue with which they can wound the president and the party. Their template for this is what followed President Clinton’s health care reform bid; after it died on the table in Congress, Republicans regained control of both houses. Gov. Dean points to Republican Sen. Jim DeMint of South Carolina, who vowed the health care plan would be Mr. Obama’s Waterloo, as proof.

Simmering anger about the bank bailout, the auto bailout and the stimulus may have found enough heat from the health care plan to bring the anger to a boil.

Third, talk radio and Fox News commentators such as Glenn Beck, Rush Limbaugh and Sean Hannity have worked, consciously it seems, to whip their viewers and listeners into a frenzy. They fancy themselves latter-day Tom Paines and use apocalyptic terms and intimate that a public option health insurance plan — no different from Medicare or Medicaid — is akin to tearing out the nation’s democratic foundations.

As with the Fox News-sponsored tea parties, talk radio gives the illusion of a large movement rather than an angry and vocal minority, which further emboldens critics.

And last, the anger may be a conservative reaction to eight years of watching the left castigate President Bush in the harshest of terms.

If the president is to win the health care fight — and he must to fix this dysfunctional component of the economy — he must understand the anger, work to counter it, but also accept that a large part will remain.

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