The health care shouting match is raging across the country, and proponents of fixing our broken health care system are losing.

Why?

A majority of Americans say they favor universal health care. Most doctors support a Medicare-for-all, single-payer system.

Yet to watch video of the health care shout-downs at town hall meetings, where members of Congress are drowned out by raging anti-health-care-reform activists, is to see the very idea of health care reform overwhelmed by populist rage.

The most obvious reason for the display of wrath at the town hall meetings is the coordinated strategy—uncovered by Think Progress—by lobbying and public relations firms, including Dick Army's FreedomWorks.

Think Progress got hold of a memo written by Bob MacGuffie, a volunteer with the FreedomWorks website Tea Party Patriots, instructing members how to infiltrate town halls and harass Democratic members of Congress. Among the tips:

– "Be Disruptive Early And Often: ‘You need to rock-the-boat early in the Rep’s presentation, Watch for an opportunity to yell out and challenge the Rep’s statements early.’ ”

– "Try To ‘Rattle Him,’ Not Have An Intelligent Debate: ‘The goal is to rattle him, get him off his prepared script and agenda. If he says something outrageous, stand up and shout out and sit right back down. Look for these opportunities before he even takes questions.’ ”

One of the services FreedomWorks offers is setting up amateur-looking web sites, giving the appearance of a grassroots effort instead of a corporate PR campaign paid for by wealthy clients.

Another tip from the memo:

–"Artificially Inflate Your Numbers: ‘Spread out in the hall and try to be in the front half. The objective is to put the Rep on the defensive with your questions and follow-up. The Rep should be made to feel that a majority, and if not, a significant portion of at least the audience, opposes the socialist agenda of Washington.’”

Clearly, the shout-downs at town halls are not a measure of public antipathy to health care reform. They are the product of political organizing. And that organizing is cynical, deceptive, and funded by special interests. All that is true.

But above all, it is effective political organizing.

If proponents of universal health care want to get their message across, they should get a kick in the behind from the spectacle of the August shout-downs.

The Obama Administration and Democrats in Congress are taking to the public a compromise plan that includes a heartbreaking, and potentially deal breaking, compromise with the drug industry. Not only is this not single-payer, universal health care, it turns out this Administration has promised the drug companies that it will not, under any circumstances, negotiate for better prices on prescription drugs.

There should be crowds showing up at these meetings to shout about that.

Instead we have a face-off between the civilized voice of the Washington Establishment on behalf of incremental reform, and the wild-eyed mobs that decry these incremental reforms as "socialism" and suggest that expanding access to health care will end in euthanasia.

There needs to be another voice in this debate.

Really, the special interest groups in Washington are the ventriloquists behind both sides of this drama. For the drug companies, at least, it is a win-win.

Anyone who takes what is left of the "public option" in Obama's health care plan--the closest thing to a universal Medicare plan--will continue to pay as much as three times the prices patients in Canada, Japan, and Western Europe pay for the same drugs. We will continue to subsidize the drug company CEOs' salaries and advertising budgets. The HMOs aren't quite as secure. But they don't face extinction, either. We will retain the private health insurance bureaucracy. And, it appears, we will set up a "public option" that doesn't pose a serious threat to the expensive and inefficient HMOs.

If the outcry over the "socialist" reforms Obama is proposing is any measure, a fight to establish a national health insurance system would be a historic battle. It would involve a frightening change, not only for the people who can afford to hire lobbyists, but for the millions of Americans who would stand to lose their jobs in the massive American HMO bureaucracy. That is no small concern.

One thing is certain, though. It is going to take a big, loud, well-organized grassroots effort to overcome institutional opposition to real reform. The shouters know how to mobilize that kind of effort. People who actually want to help Americans get the health care they deserve should seize the platform of these town hall meetings, surround the shouters, and demand that members of Congress and the Administration put single payer on the table.

Updated August 12:

Obama hit back at critics in his town hall meeting in New Hampshire, calling out the more outlandish claims people are making about a government plot to deny health care to seniors, and asking citizens to talk to their neighbors and "spread the facts."

We are closer than ever to health care reform, but it isn't going to be easy, the President said. If it were easy it would have happened already. He also noted that change doesn't come from Washington, but from below.

All of that is true. And yet the situation we are in currently is disheartening.