With the fight for health care reform about to climax, the pro- and anti-reform sides mustered in Raleigh Thursday for one last blast with the bullhorns. From one side of Fayetteville Street, Obama-style, “Yes, We Can!” From the other side, in counterpoint, “No, You Can’t!”

Apt discourse for a subject that, though critically important, has been turned to bathos by its Tea Party antagonists and Democratic backers alike. The former are sure that the federal government can’t do anything right and is wrecking America. The latter say it’s the big corporations. But if the federal government’s in bed with the big corporations, where does that leave us?

On the Tea Party sidewalk, about 75 folks were gathered with a simple message: Health care is not a right.

Think of it like flight insurance, said Bill Randall, a Republican candidate for Congress in the 13th District (Democrat Brad Miller’s seat). If you buy it, you “transfer the risk” that your flight will crash or not take off or whatevernow the insurance company owns that risk. But if you don’t buy the insurance, “you own the risk.”

Same with health care, he said.

While mingling on the Tea Party side, I met Frank Livingston, a Garner man and a retired chief in the fire services of the Army and Air Force. Livingston had the hearty look of a man ready to fight a fire any day, all day, even with his wooden leg. (He knocked on it through his pants.) He was engaging, if down on government.

When I asked what brought him out to oppose HCR, Livingston responded that he is “trying to save America from radical Islam.” Huh? But there was a thread to his thinking. Al-Qaida, being damnably clever, finished off the Soviets by luring them into a war in Afghanistan, he began. With that fact hanging, he moved smoothly to immigration and the undoubted interest of illegal immigrants in having government-paid health care. Al-Qaida is all for this because it means to “break” America under the weight of our accumulated debt, Livingston said, which totals $110 trillion. (His figure.)

What turned Livingston against the government, I gathered, was his experience with military firefighters, a job he thought could be done better and more cheaply using volunteer soldiers. Instead, the military made firefighting a full-time gig, complete with “diversity” rules and female fighters who couldn’t carry their weight. Not that there was all that much weight to carry. “Lot of guys sitting on their ass, playing with Spotty” is how he described one unit.

And health care? Well, where he grew up, in rural Missouri, the local doc charged $15 a visit, or he’d trade you for chickens. The doc predicted, in 1965, that the enactment of Medicare would destroy the health care system, Livingston recalls. And so it has, he said. You could look it up.

So I did. In 1964, per capita spending for health care in the U.S. was $196, according to the official National Health Expenditure Accounts. In 1990, it was $2,810. In 2008, $7,681.

Medicare didn’t cause health care inflation. But it didn’t help either. Add government subsidies to a bloated private system and what do you get? More bloat.

The country is spending almost 17 percent of its gross domestic product on health care, far in excess of other industrialized nations, for results thatoverallare mediocre.

No question, then, that it’s too expensive. And it will only get worse, said Bob MacRae, another Garner man, if the Obama administration has its way and health insurance becomes a welfare program.

MacRae, a Korean War veteran, gets treatments for a wartime wrist injury at the VA Hospital in Durham. Through his job, he also has private insurance, which he sometimes uses for the same treatments in a doctor’s office. The VA’s charge is always higher, he said. When he asks why, the answer is: “What do you care? You’re not paying for it, we are.”

We, meaning the taxpayers. “Government overspends on everything it does,” MacRae says. “It’s full of deceit and waste and it always costs twice as much.”

“So we trust the corporations?” Pam Hawe, who is president of Chatham County Democratic Women, was among the 250 on the pro-HCR side. She, too, worked for the Department of Defense before retiring. Her husband worked in local government in Virginia. They retain insurance coverage through his former job. “So, yeah, we’re covered. And we could stand on the other side with them and not be bothered.”

Hawe wasn’t about to offer a simple argument, though, for the reform legislation. “I don’t know that anybody understands it well enough,” she said. “Or if they say they do, they worry me.”

What she does know, however, is that access to good health care is a right, and the current system denies it to many. People with pre-existing conditions are at risk. So, too, are low-income people whose jobs don’t come with coverage. “I’m willing to go with something different than what we have,” she said. “Will the first effort be flawless? I doubt it. They never are. But at least the people on this side are willing to talk about it and work at it.”

She is pro-public option, she added, “because I trust our representatives more than the corporations.”

Yes, but our representatives have dropped the public optiona Medicare-style plan that would’ve competed with the private insurers and, just maybe, forced prices down.

When the Democrats dropped the public option, while requiring that everyone buy private coverage, they gifted to the tea party its argument about making a bad situation worse.

We progressives should be the ones railing about wastewaste in the military, our wasteful addiction to imported oil, and waste in the health care system.

All are related to the stagnation of the American economy compared to other industrialized nations where military spending is much less, gasoline taxes are much greater and health insurance is socialized, usually in the form of a government-run system.

But instead of being able to argue that our brand of health care reform will cover everyone and save money, we are reduced to arguing that it will cover almost everyone and add only a little to our giant health care tab.

When the other side says a little always turns into a lot, are they wrong?

Health care reform was a cause we were proud of until the Democrats in Washington got hold of it. Now, our best case is, as Hawe said, that after it’s enacted, we’ll make it better.