As discussed previously, a repeal of the device tax faces longish odds. Opponents of the tax have punted to a suspension of the tax as was disclosed by a letter from nearly 20 members of the U.S. Senate, a move purportedly prompted by the short turn-around from the date of the IRS’s final rule to the effective date of the tax.

Despite the disclaimers, it’s important to point out that you clearly don’t believe a repeal has any chance in the short term if you’re arguing for a suspension. So let’s ask ourselves what sort of headwinds the device tax discussion faces in Washington.

Both President Obama and House Speaker John Boehner have their constituencies, which is only part of the reason it’s difficult to close the gap. There are, after all, serious ideological differences. The original battle lines were drawn at allowing the Bush-era tax cuts to lapse for those making more than $250,000 a year (Obama) versus no increases in tax rates (Boehner), and each of them has nudged a bit on that point.

Fiscal conservatives are still demanding more serious cuts to mandatory spending programs (Social Security and Medicare) than the White House has offered, however, and Obama has to reckon with his constituencies if he bends too much on that score. Rumor in Washington has it that Obama is loathe to bend too much this time around because of what is seen among liberals as too large a set of concessions in last year’s budget sequestration negotiations. After that legislation was agreed on, nearly everyone was up for re-election, making a final deal this year highly implausible because of … well, because of the election.

I might also point out that among those with the President’s ear is the doctor lobby, which everyone in Washington probably sees as a proxy for the senior vote, a constituency that’s not going anywhere anytime soon.

In response to the stalled fiscal cliff negotiations, Boehner indicated he would allow a Dec. 20 vote on a bill that would set the bar on income tax rate increases at $1 million, a level that a leading Democrat, Sen. Chuck Schumer, has endorsed. The problem is that this bill may pass the House, but has no chance in the Senate (which by the way has passed no spending bills at all for fiscal 2013).

The disingenuousness on the other side is even more brazen. President Obama used the slaughter of children at Sandy Hook in an attempt to get Republicans to capitulate in a televised set of comments on Dec. 19. It was breathtaking even by the standards in Washington, but Boehner is determined to push the bill onto the floor for a vote, and so it goes.

The problem for the device tax is that the intractability of the positions of the two sides, which has already clobbered any prospect of a repeal, now seems likely to kayo even a suspension.

There’s an old saying in the public relations business that states basically, “may your bad news be buried under even worse news.” Conversely, the prospect of your legislation being buried under something politically heftier is a problem, and is precisely the dilemma faced by opponents of the device tax.

Add to all this the fact that Obama has argued against even a hold-up in the device tax, and it’s tough to avoid the conclusion that the corpus formed to hold off the tax is either dead at the scene or in critical condition. The only thing that’ll save the patient now is a miracle. Those who are agnostic will not hold their breath.

Dec. 21 update: The House bill Boehner had hoped to pass, which would have set the tax bar at $1 million, was pulled due to lack of support. There is an exceedingly high probability at this point that Jan. 1 will arrive with no resolution to the fiscal cliff issues. Stock markets are reacting badly to the news, and U.S. debt instruments are snaring larger returns, which boosts the government's borrowing costs. Will Moody's further downgrade U.S. bonds as a result? The device tax suspension effort is buried, and so in all likelihood is the push for repeal.