Winks and nods, back-room deals, arm-twisting, bribes and meaningless executive orders. Not one Republican vote, and lacking support from 34 of their own members, just 219 Democrats finally rammed a massive health-care entitlement down the throats of 300 million Americans.

The processes and procedures, the ­supposed integrity of our system, whereby our leaders will govern by the consent of the governed, was put in jeopardy last week. Clear majorities as far back as July and August of 2009 illustrated that the public was against the reform packages as written, and the numbers of Americans against reform kept growing until last Sunday, when the bill was finally dragged across the finish line.

What is most upsetting to so many Americans is not that a bill was passed, but the way it was passed. And at the end of the day, those against it wonder why it had to happen this way and what it means for America’s future.

Almost no one during the year leading up to final passage thought reforms in our health-care system weren’t necessary. Most everyone agreed that fixes were in order, particularly in the areas of Medicare, lowering overall costs and finding ways to insure the uninsured. This was what the public thought was meant by reform, and most everyone supported it.

Republicans were in no ­position to stall, or not work with Democrats. They’d lost elections and the support of independent voters almost to the point of the party’s ­extinction. President Obama, riding a tidal wave of public good will, came to Washington saying he would finally change the tone, be transparent and get things done in a bipartisan way.

All the ingredients were in place for targeted and incremental reforms to a health-care system, which has problems but is still generally perceived to be the best in the world. Why then did Obama and the Democrats have to pressure and cajole to the finish line a massive new federally run entitlement program no one really understands and will undoubtedly drive up our deficit?

The answers to these questions are many, and this story is far from over. But a couple of things seem apparent at this point.

When President Obama took office, our economy was in deep recession. Banks were failing, car companies were failing, the housing market had collapsed, unemployment was skyrocketing, and at every turn, instead of working within the existing system and targeting the areas needing new regulation or reform, his solutions appeared to the public as either huge unfunded spending measures in a time of fiscal crisis, or a means to grow and consolidate power within the federal government.

Deficit spending of tax dollars to bail out Chrysler and General Motors to the point that public ownership is now 65 and 60 percent respectively scared those who hold that competition in a free marketplace is important to capitalism. When the president talks about crippling banks and capping CEO salaries if they don’t fall in line with new finance regulations, Americans hear rhetoric that isn’t in keeping with our ideals of commerce and freedom. It scares people.

So when Democrats began to talk health-care reform, and their early goal was to include a public option buried within 1,000-page proposals that many congressmen said they hadn’t read, they began to lose the support of Republicans and the American people.

When huge protests and town hall meetings across the country took place, begging Democrats to slow down and join with Republicans to make reforms without destroying the existing system, and no one listened, the public began to get loud and frustrated.

Finally, after Republican Scott Brown won Teddy Kennedy’s Senate seat in Massachusetts saying he would never vote for the reform bill we now have, many hard-working Americans now wonder whether this was ever about health care at all, or simply an effort to consolidate federal powers.

Most Americans are confused and worried by what just happened, and it is a misreading to think their upset is a lack of compassion, or that they didn’t want health-care reform. They are scared that the “ends ­justify the means” way in which Democrats passed this bill threatens the Constitution, our founders’ intent, and our way of life.

Geoff Cutler is owner of Cutler Tree LLC in Southern Pines and is a regular contributor to The Pilot and PineStraw magazine. Contact him at geoffcutler@embarqmail.com.