"Patience," we are told, as if we were children pestering an adult for candy. As if health care reform is some petty treat easily dispensed at will. As if we actually have more time than necessary and sitting still will lead to satisfaction of our hunger. What a warm, soothing load of sweet-smelling crap.

I'm sick to death of hearing how progressives are just Chicken Littles who don't understand that everything is going as well as it can and we should just trust that (Dreams from My) Father Knows Best.

Is the sky falling? No, of course not. Not unless by "sky" you mean the chance of passing real health care reform--in which case, the sky may not be falling, but the stars we steer by surely are.

Multiple polls show support for reform is dropping. The Senate Finance Committee is falling into line with arch-conservatives. The White House is falling back on the Public Option. And moderates who voted for Obama are falling all over themselves to make excuses for the president's inability to speak up for what he says he favors. (Is it a secret plan to confuzzle the GOP? Is it a coded message to his base?)

Moderate Democrats aren't Chicken Littles, that's for sure. Nothing ruffles their feathers. On the other hand, ostriches are pretty oblivious to danger, too. They don't seem to notice that just above their heads, the only lines in the sand have been drawn by those who want reform delivered DOA.

The danger is multi-faceted. With the August recess half over, anti-government skeptics are winning the message war. The legislation is being worked over and beaten up on--and not for its own good. And Obama can't bring himself to hammer on why a Public Option is important.

Worst of all, the moderate Democrats and independents who helped elect Obama don't seem to realize that health care reform will either be the first great victory of his presidency or the first of many resounding defeats. Health care reform is the main event. This is the issue that he has to win--and win big for the home team--if he has any chance of advancing his agenda on other issues like immigration, financial reform, labor issues, the budget deficit, and on and on. If Obama thought he could do it later, or incrementally, he would. But there is no later. There won't be a second term if he doesn't deliver something he can call reform this year.

I'm not suggesting we all bolt from the party. I'm not suggesting we cuss out our congressman. I'm not suggesting we slow our activism.

On the contrary, fight now as if your life depends on it. It very well could if we don't pass substantive reform of our health and insurance system.

What I am suggesting is that it's not only perfectly reasonable but perfectly patriotic to hold the feet of every elected official--including the president--to the fire of our support. If you haven't sent an angry FAX to Washington lately, you really should now. If you haven't demanded to speak with someone in your senator's office who handles health care policy, you should now. If you haven't emailed the White House, do it.

And if you are considering jumping parties or supporting primary contenders, that's fine. It doesn't hurt now. It actually helps change minds in Washington, and if you want, you can change your mind before you have to change your vote. But you owe it to yourself to first rattle the cage as hard as you can for reform that includes a Public Option.

The people we sent to Washington aren't stupid. They know what counts: not polite disagreement but the raw power of vocal dissent and arm-twisting. If you thought otherwise, keep your opiate of patience. I don't use the hard stuff.