As you might recall, President Bush practically gushed over Sen. Edward Kennedy during last month’s State of the Union address. He praised the Massachusetts senator for help in getting the administration’s education bill through Congress.

“I know the folks at the Crawford coffee shop couldn’t believe I’d say such a thing,” Bush beamed, “but our work on this bill shows what is possible if we set aside posturing and focus on results.”

Washington friendships aren’t eternal or predictable. On health-care reform, the political planets already have realigned to more familiar election-year orbits. Kennedy’s immediate reaction to the president’s reform plan was to proclaim it “just another broken promise” to senior citizens.

In the past decade, health-care reform has had some uncertain starts and stops. Oddly constructed and poorly communicated, the Clinton health-care plan was a fast track toward an even more unwieldy health-care bureaucracy. It left such a bad aftertaste that for years few Democrats wanted to wade into this historically Democratic issue. On the other side, Republicans weren’t all that eager to go out on a limb, either.

Anyone who has had difficulty holding onto insurance after a job loss, works for a company that offers no health benefits, is priced out of the private insurance market or simply is lost in a maze of managed care regulations and provisos understands the need for health-care reform.

But finding safe ways to keep the issue alive has provided more political chits than actually solving it. Key elements of the Bush plan such as medical savings accounts, tax credits and flexible spending changes have growing middle-ground support from both parties. Yet the opposition at the outer edges of each party is formidable.

Trial lawyers and liberal Democrats will press to expand the provisions for dissatisfied patients to sue, a certain political nonstarter for Bush, who remains reluctant to expose companies to unnecessary lawsuits and damages. And within the Republican Party, the idea of health tax credits could face challenges from a conservative wing that sees such provisions as an undue expansion of the tax code toward another entitlement program.

The key to meaningful health-care reform is to devise a system that encourages substantial participation and flexible options. The president’s plans for expanded medical savings accounts which would allow individuals to control their medical spending and cart benefits from job to job are part of the answer. So are the proposals for flexible spending accounts, which would eliminate the “use-it-or-lose-it” feature in many corporate health plans. And if properly constructed, health-care credits would help some of the 40 million Americans who have no health insurance.

The education bill passed when Kennedy saw the train moving out and he opted to play conductor instead of victim on the tracks. But the economic stimulus package failed in the Senate when the most partisan edges of both parties eroded any hope for compromise.

There is little doubt that Kennedy wants to do something for uninsured Americans and senior citizens and presumably will be talking with the White House. But with deficits, wartime spending and elections that will determine the power axis in Congress, compromise isn’t certain.

Health-care reform can be a bipartisan win like the education bill. Or the Senate Democratic leadership’s reluctance to provide the president with even a partial victory on health care can turn this debate into a stimulus package-like train wreck.

The president’s health-care agenda can succeed, but it will take some help from his new best friend.

Jim Mitchell is an editorial writer and columnist for The Dallas Morning News. His e-mail address is jmitchell@dallsnews.com.