It's his fault. There's no doubt about it. And he's going to pay the price. We're all going to pay the price.

With authority comes responsibility. So President Obama is responsible for the outcome of the U.S. Senate race in Massachusetts, no matter the weakness of the local candidate, Martha Coakley. And the race does matter. Don't let the Democratic spinners tell you differently.

The real story is this: The health-care debacle in Washington led to the loss of a crucial Senate seat, and it may be an indication of things to come. Candidate Martha Coakley didn't fail. Not really.

Sure, she was a miserable campaigner. But even the Lion of the Senate, Ted Kennedy, may have had trouble holding on to his seat with the way the health-care debate has been going. He may have failed even in the People's Republic of Massachusetts - the most liberal, dependably Democratic, state in the Union.

But it would not have been his failure, either. No, it is Obama's. Pure and simple. The president failed because he did not lead the health-care debate. He did not even support the conversation.

He let others define the issue and define the conversation. He allowed party hacks to fashion the legislation. Then he watched fecklessly as the Republican Party leadership lied shamelessly and delayed unconscionably, all the while brainwashing the American public about what health-care reform was and what it wasn't.

Obama was silent to all that. Worse, the president proved he was the ultimate inside-the-Beltway operator when he allowed a political bandit like U.S. Sen. Ben Nelson of Nebraska to extort a ransom for his support of what had become an impotent health-care bill. Obama did so, apparently, to get something - anything - passed.

The president should take responsibility. And he should apologize to the American public. Then he should lead. And if he can't lead, he should get the hell out of the way and let the Republicans lead. We know what they stand for. We know what they'll do. What is the change you believe in, Mr. President?

How about this? Here's what you do, Mr. President. Here's what you say:

"Our health system is broken. Annual, double-digit increases in the cost of health care and medical insurance over the past three decades are unsustainable, unacceptable. Everybody knows it. And that's before we mention the 45 million Americans who are uninsured.

"Universal health care is the answer. From now on, Medicare is not just for the elderly. It's for everyone. Don't worry about the private health insurers who have been milking you for the last half-century and denying coverage when you needed it. A single-payer system will take care of them.

"Don't like it, Republicans? Don't like it, Blue Dogs? No problem. Block it if you like. We, the members of the Democratic Party, will be happy to take the issue to the voters come November, and the November after that, and the November after that."

But no. Democrats and Obama won't do it. They'll let the worst of the right wing define the issue. They'll cower in the corner while the likes of Mitch McConnell have the temerity to claim the system is not fractured, and the people, the voters, like things as they are.

Or, worse, they'll sell their souls, and the rest of us down the river, to get any kind of deal they can call health-care reform no matter how bad, no matter the cost in principle.

Obama and his Beltway cronies have wallowed with the worst of K Street Washington on this issue - and come away with less than a 60-seat, filibuster-proof majority in the Senate.

The same people who think tax cuts would cure the common cold will be back in charge before you know it because of this lack of leadership - this lack of principle.

That's change you can depend on, Mr. President.

Jim Hefner, who lives in Southern Pines, is professor at the UNC-CH School of Journalism and Mass Communication in Chapel Hill. He is a former vice president and general manager of WRAL-TV in Raleigh.