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Senate Democrats, after consultation with President Obama, removed both the public option and early Medicare buy-in for those between 55 and 64 years of age from the Senate health care reform bill on Tuesday in order to satisfy Senator Joseph Lieberman and ensure his support to close debate on the legislation. Lieberman, an Independent from Connecticut, is part of the Senate Democratic Caucus, and held the last vote needed to close debate and bring the bill before the full Senate for a final floor vote.

Closure of debate requires 60 votes – the full Democrat majority plus Lieberman. Final passage only requires a simple majority of 51 votes in favor of the bill.

President Obama surrendered his position on both the public option and early Medicare buy-in, reversing his earlier insistence on those two key elements. Obama seems willing to trade-away any actual reform in return for final passage of the bill before year’s end.

And without these two critical provisions of government-subsidized health coverage there is no actual health care reform in the Senate bill. Instead it becomes a minor adjustment of insurance regulations that does nothing to limit the high cost of care or the shortfall in coverage for all Americans.

In other words the Republican opposition, through Lieberman, has managed to kill any real health care reform effort in the Senate. Some are joking that Lieberman’s position is no surprise considering his state is home to many insurance companies, but the threat of Lieberman stalling legislation in order to hold-up the Senate for his own agenda is making him a majority of one. How long can the Democrat majority allow itself to be stymied by Lieberman’s one-vote veto power?

More important, though, is President Obama’s seeming willingness to accept any legislation that has “Health Care Reform” written on it, regardless of its actual consequences to the American public. Obama appears obsessed with his place in history more than anything else – he has more than once alluded to his position as the first president to sign large-scale health reform legislation since the start of the 20th century. And apparently that act of signing is more significant to his administration that any actual reform the legislation may contain.

Of course, the Senate bill will be “reconciled” with the bill passed by the House of Representatives a few weeks ago, but that legislation has also been watered-down in order to get swift passage for Obama. The Senate and House chances of coming back with any kind of real reform legislation are now almost zero.

And so the entire health care reform effort has been an excercise in politics-as-usual for Washington, and futility and frustration for the American people, who are once again left out in the political waiting room as politicians struggle for ideological points and a newly elected president struggles to build a historical legacy, regardless of how empty the ideologies and that legacy may be.