President Obama's speech Wednesday started with math (or something close to it) and ended with a poetic encomium to (and from) the late Ted Kennedy. There's a reason for that balance. He had two goals in mind last night: 1)Allay public concerns that the costs associated with the program are too much to handle in the current economic circumstances and, 2) demonstrate to Democrats that he's willing to stand up and fight for his policy.
The speech began with a nod toward transition: Obama reminded the public that the last time he addressed Congress, the country looked like it was about to fall into an economic meltdown. He assured all that while the nation wasn't yet out of recession, the worst appeared to have been averted. He then pirouetted from there to explain why reform was essential now:
Then there's the problem of rising costs. We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it. This is one of the reasons that insurance premiums have gone up three times faster than wages. It's why so many employers – especially small businesses – are forcing their employees to pay more for insurance, or are dropping their coverage entirely. It's why so many aspiring entrepreneurs cannot afford to open a business in the first place, and why American businesses that compete internationally – like our automakers – are at a huge disadvantage. And it's why those of us with health insurance are also paying a hidden and growing tax for those without it – about $1000 per year that pays for somebody else's emergency room and charitable care.
Finally, our health care system is placing an unsustainable burden on taxpayers. When health care costs grow at the rate they have, it puts greater pressure on programs like Medicare and Medicaid. If we do nothing to slow these skyrocketing costs, we will eventually be spending more on Medicare and Medicaid than every other government program combined. Put simply, our health care problem is our deficit problem. Nothing else even comes close.
In addition to concerns about whether the already-insured had anything to fear, the biggest worry for the public is the cost factor -- whether a nation drowning in red ink can afford to take on another trillion-dollar burden. Obama turned that fear around -- "our health care problem is our deficit problem." Whether the public will accept that formulation or not, the president was smart to tackle it head-on.
Of course, those closely paying attention did also hear the president declare that the reform effort can be paid for by rooting out "waste," "fraud", "abuse" and "inefficiency." But as has been noted before, politicians have been pointing since time immemorial to variations of those phrases in promising savings in government programs. Unless there is something more forthcoming from the administration, the public's concerns about increased deficits will only continue.
The other main goal for the speech was undoubtedly to reassure the president's own Democratic base. On that, he likely succeeded very well. The Ted Kennedy card (literally, a letter from the departed senator) was deployed expertly. Rather than sounding ghoulish, Obama used the moment to, once again, celebrate liberal lion Kennedy's history with the issue --but also connecting that Democratic Holy Grail of health care with examples of Kennedy working with Republicans. It was an ironic jiu jitsu move: Obama was as overtly partisan as he has ever been (two references to the costs that grew out of George W. Bush's Iraq and Afghanistan missions and his "tax cuts fr the wealthy"), but used Kennedy as an example of bipartisan efforts, pointing to legislation he developed with Orrin Hatch, John McCain and Chuck Grassley.
Rank and file Republicans might not have liked it, but it surely bought Obama time to keep all of his Democrats -- moderate Blue Democrats and hard-line "progressives" -- in line long enough to keep the ball moving.
Barack Obama's health care initiative is still in trouble. The president didn't put forward a brand new operating system last night, but did do a sufficient enough upgrade that the product might yet make it to market in some form.