Here's the relevant part of the interview:

How do you respond to someone who says, this is a terrific idea. More competition is always welcome. But why instead of a public option? Why not do it alongside and let a thousand coverage models bloom?

Votes. The problem is this. If you're in a 60 vote environment in the Senate, and I believe we are, because I believe reconciliation simply won't work, if you begin tallying up the votes, I believe that virtually all Republicans are against the public option and some democrats are. So how do you get to 60?

How many Democrats would you estimate are against a public option?

I don't know for certain, but I think at least three, and maybe more.

And why do you think that reconciliation won't work for health reform?

Reconciliation was never designed to write substantive legislation. It was designed solely for deficit reduction. The whole idea was you would change numbers, not policy. You would change numbers on the revenue side of the equation and the spending side of the equation.

And so, the way it works, under current rules, if your in reconciliation, you have to be deficit neutral over five years. Under the budget resolution, health care can be deficit neutral under 10 years. That's a big difference.

Two, under reconciliation, you're subjected to the Byrd rule. The Byrd rule says that anything that doesn't cost money or save money, or that only costs money or saves money in a way that's incidental to the policy, are subject to strike. The result, for instance, is that all the insurance market provisions are subject to strike. All the wellness and prevention provisions are subject to strike. The Senate parliamentarian said to us that if you try to write substantive health reform in reconciliation, you'll end up with Swiss cheese.

The rules of the Senate are largely beyond me but suddenly the unelected Senate parliamentarian, Alan Frumin, has become one of the point persons in the efforts to enact national health care reform legislation.

From Rules of the House and Senate:

Under the Byrd rule, the Senate is prohibited from considering extraneous matter as part of a reconciliation bill or resolution or conference report thereon. The definition of what constitutes "extraneous matter" is set forth in the Budget Act; however, the term remains subject to considerable interpretation by the presiding officer who relies on the Senate Parliamentarian. The Byrd rule is enforced when a Senator raises a point of order during consideration of a reconciliation bill or conference report. If the point of order is sustained, the offending title, provision or amendment is deemed stricken unless its proponent can muster a 3/5 (60) Senate majority vote to waive the rule.

Back in April, The Hill reported on this possibility.

The fate of healthcare reform may come down to the decisions of one unelected congressional officer: Senate Parliamentarian Alan Frumin.

Frumin will decide which proposals can be passed through a special budget process Democrats are considering to move healthcare reform this year. Bills submitted through the process, known as reconciliation, aren't subject to filibusters, meaning Democrats would need only 51 votes -- and probably no Republicans -- to win approval.

If Democrats decide to go the reconciliation route, Frumin will face pressure from both parties to rule in their favor.

"It's horrible," said Robert Dove, Frumin's predecessor as Senate parliamentarian. "It's absolutely horrible. It puts the parliamentarian in a terrible position. I have done it myself and been extraordinarily criticized. I assume he will be also."

Frumin, who did not respond to requests for an interview, would hold power because he would be called on to referee the Senate's rules.

Reconciliation was created to make it easier to pass measures that directly affect government revenues, spending and debt. Under the "Byrd rule," however, senators can strike provisions that they believe are extraneous to those goals. But what is extraneous and what is relevant aren't clear, and the only person who gets to makes those decisions is the parliamentarian.

One way or the other, either Democrats or Republicans will be disappointed. It's a no-win situation, Dove said.

"I talk to him regularly. He is not looking forward to this," Dove told The Hill. "All I can tell you is he's a very good man. He will call it straight. He will make all kind of enemies."

Republicans have warned Democrats not to use reconciliation, saying that it would be undemocratic and would go against the president's talk of bipartisanship.

"My opinion is that it would be a complete disaster because you'd end up with a parliamentarian writing a healthcare bill," said Sen. Lamar Alexander (Tenn.), the chairman of the Senate Republican Conference.

Both parties are already lobbying Frumin. Democrats on the Senate Budget Committee and Senate aides from both parties have met with him to discuss the Byrd rule, named after initial sponsor Sen. Robert Byrd (D-W.Va.). Frumin told Senate Budget Committee Chairman Kent Conrad (D-N.D.) a few weeks ago that legislation passed through the reconciliation process may end up looking like "Swiss cheese," because certain provisions of a bill may survive while others are stricken, Conrad said.

"In every iteration [of our meetings on reconciliation], we're trying to understand because the devil really is in the details," Conrad said. "So we've had many discussions with the parliamentarian."

Sen. Debbie Stabenow (Mich.), another Democrat on the Budget Committee, said that she has spoken to Frumin and understands his importance.

"The practical reality is that whatever is done [in reconciliation], each section has to relate to increasing revenues or expenditures or debt. So the parliamentarian makes a judgment all the way through the process," she said.

On Alan Frumin's judgment now rests our healthcare reform efforts.