"How is it," wonders Robert Reich, the economist and former Labor Secretary, "that a decision next week by a single senator from Maine will almost certainly determine whether America's future healthcare system is still in the hands of private for-profit insurance companies and Big Pharma or enables more Americans to get better healthcare at lower cost?"

The senator in question, of course, is Maine's own Olympia Snowe. And the answer to Reich's question lies in Snowe's unique position as the only Republican of national stature who seems willing to negotiate in good faith with Democrats — and in particular with Barack Obama — on the issue of health care reform.

Indeed, in a recent interview with John Harwood of the New York Times, Snowe was downright fulsome in her praise for the President, complimenting him on his sincerity and his grasp of the issues, and going so far as to describe him as "more moderate than liberal."

That's high praise indeed from a lady sometimes called the last moderate Republican. Snowe herself has memorably said that "being a Republican moderate sometimes feels like being a cast member of Survivor -- you are presented with multiple challenges, and you often get the distinct feeling that you're no longer welcome in the tribe."

Snowe's voting record bears eloquent testimony to her estrangement from the current, ultra-conservative Republican Party. In recent years she has sided with Senate liberals and moderates — read, Democrats — on matters as disparate as children's health insurance, stem-cell research, gay marriage, immigration reform, and the District of Columbia House Voting Rights Act (which would have ended the bizarre status quo in which residents of the nation's capital have no meaningful representation in Congress).

As befits a moderate, of course, her overall voting record is mixed. She has sided with the Bush administration and with her Senate Republican colleagues on many signal issues, as detailed here, albeit incompletely.

Like a Shakespearean heroine wooed by two, mutually inimical suitors, Snowe is a serial heart-breaker. And now she seems poised to break the hearts of pro-reformers, in Maine and elsewhere, by singlehandedly killing the public insurance option that has emerged as the lightning-rod issue in the whole health-care debate.

To get a sense of Snowe's pivotal role, let's quickly review where things stand. With the death of Ted Kennedy, Democrats can count (optimistically) on only 59 votes in the Senate — 57 members of their own party plus two independents, Lieberman and Sanders. This is one vote short of the 60 needed to overcome a predictable GOP filibuster. Health-care reform — or indeed any other legislation — can thus only come about in one of two ways: if Democrats can win over a single Republican vote (while still holding their own fractious caucus intact), or if the Democratic leadership gives up on bipartisanship and decides to pass whatever bill finally emerges from the House-Senate conference committee by the process known as reconciliation, which requires only a simple majority vote.

The latter course — which was used successfully by the Republican-controlled Congress in enacting the disastrous 2001 Bush tax cuts — would render Olympia Snowe irrelevant. It would also likely produce a bill much more helpful to Maine citizens struggling to afford health insurance. But for a couple of reasons — most importantly President Obama's yearning to achieve some kind of broad consensus, which seems to be hard-wired into his political DNA — it probably ain't gonna happen.

Predicting the outcome of this particular debate is hard, but not impossible. Here's one likely scenario: With the blessing of Olympia Snowe, a bill is passed which includes a requirement that all Americans buy into the health-insurance system, but fails to provide them with any low-cost, not-for-profit public insurance option which would make it truly affordable. Hard-pressed families would be forced to take out a private health plan and contribute to the further enrichment of the insurance industry. Partial subsides would be available to families earning less than 300 percent of the poverty level, but these subsidies would be scaled back — again at Snowe's insistence, in the name of fiscal discipline — so that a typical middle-income family would still be paying in excess of 10 percent of its annual income for a needlessly expensive private policy.

There's no guarantee that that's how it will go — Snowe is playing awfully coy as to how much her coveted vote will cost. And why not? As the only Republican in the game, she's got the market cornered.

"What Does Olympia Snowe Want?"  asks CBS News. I think the answer is pretty clear. She wants the perfect pitch: a softball lobbed across the aisle that fulfills her singular vision of "limited government, individual opportunities, [and] fiscal responsibility" — ideals that she considers the traditional principles of the Republican Party. It's not an unreasonable position. But it does make you wonder who really won the last election.

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