- He says the deficit keeps him up at night. Well, as he used to remind us frequently, say nine months ago, health care reform is entitlement reform. Bend the health care cost curve, and the Federal government's core commitments are affordable; fail to, and they're not. But those magic seeds of cost control packed into the Senate bill that Atul Gawande catalogued so lovingly will not become law unless the House passes that bill.
- Obama's core campaign promise, reiterated in an email to supporters following the speech, was "restoring economic security for struggling middle class families." That cannot be done as long as losing a job means exposure to catastrophic medical cost, or as long as having the wrong job can make insurance an impossible dream, or as long as millions of "insurance" policies leave holders exposed to catastrophic costs.
- He said that change is not easy, that he wanted to tackle the hard stuff, . In the health care reform process, Americans got full frontal exposure -- overexposure, according to conventional wisdom -- to the mammoth difficulties and not-always-destructive competitive tradeoffs of moving major legislation through the United States Congress. That leaves Obama with a double message: let's fix the process/let's make the process work. Both messages will spiral to massive fail if a comprehnsive bill does not pass.
What he delivered was pure Obama, for better and worse. As Ezra Klein pointed out just prior to the speech, at a campaign crisis point Obama famously said, "give me the ball." But his M.O. is to put the ball in other people's court -- with a clear or not-so-clear play call -- and that's what he did last night. In the process, he threaded incredibly fine rhetorical needles. I wanted to say, "he challenged Republicans to do x" and "he challenged Democrats to do y," but part of his balancing act was to challenge "Congress" as a whole and so stay above the partisan fray while trying to point the way members of his own party. Here are the challenges he laid down that I couldn't quite divvy up:
As temperatures cool, I want everyone to take another look at the plan we’ve proposed. There’s a reason why many doctors, nurses, and health care experts who know our system best consider this approach a vast improvement over the status quo. But if anyone from either party has a better approach that will bring down premiums, bring down the deficit, cover the uninsured, strengthen Medicare for seniors, and stop insurance company abuses, let me know. Here’s what I ask of Congress, though: Do not walk away from reform. Not now. Not when we are so close. Let us find a way to come together and finish the job for the American people.You might say that the challenge to produce new ideas was directed at Republicans, and the challenge to finish the job at Democrats. But those injunctions could just as easily be reversed. It's Democrats who are flailing about with 'new ideas' to dismember the bill (and the clear implication of Obama's 'let me know' sarcasm was that there is no viable solution other than building on the Senate bill already passed). And "come together and finish the job" is at least a rhetorical gesture toward bipartisanship.
In his ABC interview last week, Obama had bound himself last week to make one more such gesture to bring Republicans back to the process. He did that in the slightest way last night -- inviting them to supply new ideas that he knows they don't have to meet goals that they don't honestly share and to 'come together' around a bill they've rejected.
As for his message to Democrats: it was sketched in. He spoke eloquently if briefly about the strengths of the bills that have passed the House and Senate and said (implicitly, mainly to his own party) "Do not walk away" and do not "run for the hills." What he did not do -- and what, as I recognized first with dread and then with some resignation last night, he could not do in this forum -- was tell Democrats how to proceed.
That's the task before him now. TPM reports that House and Senate Democrats are locked in a "you go first" standoff - Senators insisting that the House has to pass their bill, House reps insisting that the Senate must first prove that they're willing to advance House goals through reconciliation. The test of leadership continues.
Postscript: My own Congressman, Bill Pascrell, D-NJ (8th District) is working to kill comprehensive health care reform. A message to his constituents is here, on South Orange Patch.