What if the president's faltering health care agenda is not the fault of mismanagement or a lack of will from voters, but the undemocratic and idiosyncratic U.S. Congress? Hendrik Hertzberg argues just that in this week's New Yorker: "The [legislative] process that results is less like the Roman Senate than like the Roman Games: a sanguinary legislative Colosseum where at any moment some two-bit emperor is apt to signal the thumbs-down." Hertzberg says that our "ramshackle political mechanisms" are tripping up the needed introduction of a single-payer system. "Ultimately," Hertzberg writes, "real cost control will require a strong push away from fee-for-service medicine." The columnist doesn't see that change coming soon.