President Obama spoke loudly but carried a small stick Wednesday night, when he outlined what’s left of his healthcare reform agenda in a rare address to a joint session of the Congress.
Noting that “it has now been nearly a century since Theodore Roosevelt first called for healthcare reform,” the president told skeptical legislators from both sides of the political aisle. “I am not the first president to take up this cause, but I am determined to be the last.”
That was one of several takeaway lines of the night.
Another, delivered to members of the House and Senate who have just returned to Washington after an August of brutal town hall meetings, was: “The time for bickering has passed. The time for games has passed. Now is the season for action. Now is the time when we must bring the best ideas of both parties together… Now is the time to deliver on healthcare.”
The president was equally muscular when it came to addressing “scary stories” and “bogus claims” about “death panels” and threats to Medicare that have been spun up by insurance industry front groups in order to thwart meaningful reform. Democrats loved it when Obama told the spin doctors — in the House and Senate Republican caucuses and their media echo chambers — that: “If you misrepresent what’s in the plan, we will call you out.”
But for all of its rhetorical flourishes, this was not a to-the-barricades address by a president who was prepared to battle not just the lies about his plan but the compromises that would make universal healthcare the dream deferred.
When it came to the task of offering the explanations, arguments and details that have been so hard to come by during a frustratingly unfocused debate about how to develop a functional healthcare system for a country where tens of millions of Americans have no insurance coverage and tens of millions more are underinsured, Obama remained disturbingly vague.
He restated his determination to prevent insurance companies from denying coverage to Americans with pre-existing conditions. He proposed portability and flexibility. He pledged to bar corporate caps on the amount of care that is provided the sick. And he decried insurance company abuses that even Republicans seemed to agree–at least if applause is any measure — are “heartbreaking” and “wrong.”
These consumer protection initiatives could well form the foundation for the legislation that Obama says he is determined to sign this year, since it certainly did not sound Wednesday night like the president was going to fight for the sort of broad reforms that really would provide quality care to all while control costs.
“It makes more sense to build on what works… rather than to build an entirely new system from scratch,” Obama said, making all too clear his determination to retain the private for-profit system that has failed so miserably to deliver universal care but that has succeeded so monumentally in delivering profits to insurance and pharmaceutical corporation stockholders.
Obama still talked about “options” and “choices.” But he suggested that they would be offered mainly by insurance companies that would enjoy “incentives” — i.e., new streams of taxpayer dollars — if they agree to abide by consumer-friendly regulations and come up with strategies for covering more of the uninsured.
The government might step in to help, Obama suggested, but he painted such interventions as temporary rather than permanent. When he spoke of a “public option,” as he had to in order to keep progressive Democrats on board, the president still said: “I have no interest in putting insurance companies out of business.”
The “public option” was positioned as something akin to a consumer protection initiative for “those without insurance,” a sort of welfare program that would attract only about five percent of Americans and that would be funded by premiums rather than tax dollars.
Robust? Not hardly.
The president’s language, so strong at the start, went soft when he focused in on the public option. He even suggested that he was open to alternatives favored by Republicans and some moderate Democrats. That was something that Congressional Progressive Caucus co-chair Raul Grijalva, D-Arizona, picked up on when he said after the speech: “(The) president needs to be more direct on what the public option means and what it will do for the American people.”
The congressman warned that, “President Obama was elected to bring change and progress. I fear that if my party and the President do not appreciate the mandate the American people have given us, the people will lose confidence in the idea that they can vote for change and get what they voted for.”
Grijalva’s point is well taken.
Throughout the speech, Obama talked about “the plan” he was presenting. But a lack of clarity or line-in-the-sand commitments to pursue genuine reform of a system he described as “full of waste and abuse” created the most amusing moment of the night.
Obama was not going for laughs when he uttered the line “while there remain some significant details to be ironed out…” But he got them.
What the president was getting at was the message, repeated several times during the speech, that he was still searching for some kind of middle ground that will satisfy “those on the left” and “those on the right — even if that means supporting medical malpractice “reforms” that would make it harder for those who are injured by bad doctors, nurses and hospitals to hold the wrongdoers to account.
What Americans who have waited “nearly a century” for reform were left with was the prospect that the “great unfinished business of our society” — as the late Edward Kennedy described the pursuit of universal healthcare in a last letter to Obama–might remain unfinished under a president who means well but does not necessarily fight well.