Health Care Home Stretch

On Wednesday, President Obama appeared before a joint session of Congress to make his pitch for health care reform. A prime time joint session is perhaps the largest venue a president has to push his agenda, and Obama appeared to be on the offensive.
He started by describing the recession and recovery that has defined his short time in office, and got the first standing ovation of the night when he mentioned jobs. He said that presidents as far back as Teddy Roosevelt have tried to reform health care, but that he was "determined to be the last."
First, he described the effect of the current system on those who have insurance, some 85% of Americans. Lapses in coverage, when one moves or changes jobs, or getting dropped from a plan after getting sick are some of the major fears of many Americans. Entrepreneurs and small business owners, the spirit of America, are also affected by rising premiums, and are unable to compete against larger corporations who have fatter bottom lines. Premiums that are rising three times faster than wages are a hidden tax that most Americans never even see. A large segment of the population that has insurance are those on Medicare, and, with Medicare cost eating up a larger portion of our budget every year, Obama was able to frame health care reform as entitlement reform.
One of the more surprising elements of the speech was the amount of detail, something many of his liberal allies have been yelling for. The first was consumer protection. "In America," Obama said, "no one should go broke," from health care cost. Second was an individual mandate, saying those who choose not to have coverage are simply passing costs onto the rest of us. Thirdly was an insurance exchange, where people could pool together and buy insurance themselves. As part of this exchange, Obama voiced his support for a public option. A public option would force the insurance companies to compete in a way that was not driven by profits and stock prices.
Obama admitted that there was "significant details" to be worked out, which drew very audible laughter in the chamber. But he called out Republicans that had spread "bogus claims," such as death panels, a government "takeover," and paying for undocumented aliens and abortions. He also said he would not waste time with members who are more interested in killing reform than improving it.
In this speech, Obama seemed to be targeting Americans that know that reform is necessary, but who are nervous about how it will affect them. Polls show that most Americans are ambivalent about the current plan, if they even know what it is. What Obama is really pitching is sweeping reforms of the insurance markets, not how you receive your health care.
He closed by citing the old American argument about individualism versus collective responsibility, and by quoting a letter from Ted Kennedy, who called health care reform "the great unfinished business of our country," and a "moral issue."
So this marks the home stretch for health care reform. If Obama does not get what he wants, it will not be because he was stonewalled by the Republicans. It will be because members of his own party got nervous. If done right, health care reform could remake America for generations, and Americans will not forget it. With the Republicans lost in the political wilderness, Democrats can control Congress for the next forty years, if only they have the bravery to push a progressive agenda and restore the equal playing field in the land of the free.