Why is the Democrat's "health reform" in trouble? The short answer is lack of effective leadership from the White House.
To elaborate: Obama's decision to campaign for health care reform, like that to endorse the Afghanistan war as the "good" war, was made for tactical political reasons rather than objective cost-benefit analysis. I doubt he ever really bothered to understand what kind of reform was needed. He just assumed that Democrats in Congress would come up with something for him that would placate his progressive base even as he otherwise offended it over his continuation of Bush-Cheney policies with regard to widening warfare and evasions of the rule of law. He has failed to understand that tactical political maneuvers, however expertly executed on his behalf by experienced pols, would not produce a result of visable net benefit to the public unless guided by a well informed strategic purpose.
Obama is just a charismatic campaigner who erroneously assumed that policy "wonkery" could be safely left to others.