Senator Russ Feingold is feeling a little heat from constituents who say he didn't fight hard enough to retain a public option in the Senate health care bill.

Last week a group of protesters organized by MoveOn assembled outside the progressive Democrat's Middleton office to demand that he vote against final health care legislation if it doesn't include a public option.

But on Sunday, just after Joe Lieberman told the Huffington Post that the White House never even lobbied him to support a public option, Feingold released the following statement:

“I’ve been fighting all year for a strong public option to compete with the insurance industry and bring health care spending down." Feingold said in the statement. "I continued that fight during recent negotiations, and I refused to sign onto a deal to drop the public option from the Senate bill. Unfortunately, the lack of support from the administration made keeping the public option in the bill an uphill struggle. (Emphasis mine, not the Senator's.) Removing the public option from the Senate bill is the wrong move, and eliminates $25 billion in savings. I will be urging members of the House and Senate who draft the final bill to make sure this essential provision is included."

Saying that the President was no help to progressives was a rare move for Feingold, who went to bat for Harry Reid, praising him for resuscitating the public option back in the fall. (Reid, as Democratic Majority Leader, is the architect of 60-vote-getting compromise legislation.) Now that the writing is on the wall, Feingold went on to say that he would vote for the final health care bill--without a public option:

“. . . while the loss of the public option is a bitter pill to swallow, on balance, the bill still delivers meaningful reform, and the cost of inaction is simply too high." The final bill "significantly expands coverage" and outlaws some insurance company abuses, including denying coverage to people with "pre-existing conditions." And it expands funding for home health care and community-based health care centers.

That's not enough for MoveOn. The group urged members to sign a petition demanding that Feingold and other progressive Senators, including Bernie Sanders, Independent of Vermont, block the bill. "Health care reform MUST include a real public health insurance option that's available immediately. Don't give in to conservatives and Big Insurance!" the petition says.

But on Monday, Bernie Sanders joined Feingold in saying he would vote for the bill, despite his disappointment in the final product. Funding for community health-care centers and additional Medicaid money for Vermont tipped the balance for him. "If we don't do this now, when will we do it?" Sanders said.

Many activists believe the heavily lobbyist-influenced health care legislation is worse than nothing: It contains loopholes for the insurance industry to overcharge and underserve people, no public option to compete with those companies, a mandate for individuals to buy what could turn out to be useless insurance and line the industry's pockets without getting decent coverage in return, and a compromise on reproductive coverage that sets back women's rights. On the other side, the Obama Administration has been pretty clear from the beginning that signing a bill it can describe as sweeping "reform" puts the country on a path to universal health care and will be a big political win for Democrats and progressives. Symbolically, it pulls the country toward a New Deal vision of government as a fixer of problems.

Since the actual legislation is pretty lame, the real question is, who is right about the politics? Does passing a seriously underwhelming health care reform bill get us closer to meaningful reform? Or are we better off if the bill dies and we force the whole process to begin again?

There are legitimate arguments on both sides.

By claiming to have passed the most significant piece of domestic policy legislation since the Great Society, the Obama team can try to pass more legislation to improve access to health care down the road. That's not total sophistry. Unlike welfare reform--a bad piece of legislation Bill Clinton signed over heavy protest from progressives in his cabinet, claiming he could fix it later--health care reform would move the country in a progressive direction, if only incrementally. Expanding it would be easier than reversing it, as Clinton argued he could do with welfare.

The biggest argument for the bill is that starting over just won't happen any time soon. Once this moment is gone, if the bill fails, the whole idea of doing health care reform will sink out of sight for the foreseeable future.

"This issue doesn't come along very often," Wendell Potter, traitor to the insurance industry and an advocate of single-payer health care reform explains. That means two things, according to Potter: that it's worth passing some sort of reform, and that we should fight tooth and nail for the best deal possible.

Potter is an expert in insurance-industry loopholes, and has been busy pointing them out in the current legislation. In a recent blog, he advocated for an amendment sponsored by Al Franken, that would insist that insurance companies spend 90 percent of what they take in premiums on health care for their customers. That would radically change the industry practice of pleasing Wall Street by keeping at least 20 percent of the of money in profits--making sure not to spend too much on actual health care for people. This practice, which Wall Street rewards because it makes companies "profitable," is one of the main reasons there is a health-care shortage.

There is a legitimate argument that, absent protections like the Franken amendment and other fundamental reforms, the health care bill is just a small expansion of health care services that actually further enriches and entrenches industry. The power of the insurance lobby is such that, by failing to make a stand against it, progressives are making it stronger.

And, further, if Democrats don't start losing races when they listen to lobbyists more than their constituents, what hope is there for reform?

This is the argument public-option advocates tried to make to Russ Feingold, when they showed up at his office in Middleton.

Feingold knows he can't take his 2010 reelection for granted, despite his crossover appeal both to progressive and conservative independents. Other famous and beloved progressive Senators from Wisconsin have lost reelection, Feingold pointed out recently, at a fundraiser held two doors down from Republican opponent Terrence Wall's house. Gaylord Nelson lost in an upset after he gave us the Clean Air and Clean Water Acts.

It's hard to imagine a sizable, progressive campaign to take down Russ Feingold and Bernie Sanders for supporting the so-so health care bill.

What would be nice would be to see Obama, Feingold, and Sanders face down Republicans and insurance lobbyists in 2010 over major reform that had the kind of industry-enraging, culture-shifting power of the Clean Air Act.