President Obama’s eloquent address to a joint session of Congress was one he should have made a lot sooner, before the health-care debate started to spiral out of control.
He was too aloof and hands off at the outset and distressingly slow in answering attacks and distortions, a mistake he vowed not to repeat. "Death panels," he said, are "a lie, plain and simple."
His forcefulness was intended to reassure wavering Democrats that he would fight for health care and the new level of detail in the speech indicated that he was willing to get his hands dirty in the sausage making of legislation.
He laid down several markers. Everyone would be required to have health insurance and, once in effect, that insurance must cover pre-existing conditions and could not be cancelled or watered down. There would be subsidies for those who cannot afford insurance to purchase coverage on an exchange.
The cost of the overhaul would be a less than projected $900 billion over 10 years, "less than we have spent on the Iraq and Afghanistan wars," he said, as if that make it some kind of bargain.
Obama pledged that the health-care reform would not add a dime to the deficit and proposed a trigger mechanism to see that it did not. He drew guffaws from Republican lawmakers when he said significant details remain to be worked out. The trigger mechanism is one of them.
He also sought to give any Republicans who don’t share the party’s hard line on healthcare overall an opportunity to say they had a hand in reshaping the final bill into something more to their liking.
Obama extended the some fudge room on the "public option," which the Republicans almost unanimously oppose, saying that any bill would have to offer affordable choices for all.
And on medical malpractice reform, another Republican goal, Obama said he would order the Department of Health and Human Services to set up demonstration tort reform programs in individual states. The Republicans are not likely to be satisfied by a handful of pilot programs.
After marking time in the spring and summer, healthcare is beginning to move. The fifth and final congressional committee, Senate Finance, will shortly report out its bill with debate likely before the end of the month. And Senate Democratic leader Harry Reid predicts Congress will finish work on a comprehensive bill by Thanksgiving.
However, a key factor in the bill’s passage is basically out of Obama’s hands — how robustly the economy is recovering leading up to a final vote. Clear signs of recovery might give the lawmakers confidence that they would be able to pay for these reforms.
If a single speech could save a piece of landmark legislation, Obama’s address Wednesday night was it, but Washington doesn’t work that smoothly or dramatically.