The President's Speech In Ten Key Points
Lifting up from the political goals of the speech, here's the news that the president made:
1. He called for a bill that includes an individual mandate to buy insurance, along with a hardship waiver.
2. He give a spirited defense of the public option but was clear that there were other options, like a trigger for the future or a co-op.
3. He endorsed a plan that would cost about $900 billion ... but said he wouldn't sign a plan that added to the deficit over 10 years. The $900 billion figure might pin down Democrats later on.
4. He reached out to doctors on medical malpractice reform, endorsing a Bush-era pilot project to study approaches to rebalacing the system.
5. He threw in plenty of red meat for the left (references to the Bush wars and deficits, a strong defense of Medicare) but explicitly chided liberal activists for missing the forest for the trees.
6. Linked his argument about cost to reforms in Medicare and Medicaid -- and to a new tax on insurance companies on so-called "Cadillac plans." (This tax might be passed on to consumers... and is, at least in theory, something that unions will oppose.)
7. He made a moral case for health care -- and probably the case that liberals were waiting for him to make.
8. Most Republicans were polite, but Rep. Joe Wilson's churlishness and taunt -- "You lie" -- will be repeated ad nauseum by the media and might come to define Republican opposition to the speech.
9. The speech was heavy on ... light-specifics. As noted, there were a few new elements, but the president still left negotiators plenty of wiggle room.
10. He endorsed Sen. John McCain's idea for covering catastrophic expenses as a way of tending to the uninsured until the exchange is phased in.
And make no mistake: the details that have yet to be worked out -- members chuckled when Obama mentioned there were a "few" -- aren't details. The transition to an exchange will require that many Americans pay more money up front than they've ever paid for before. The scope of the various waivers -- for individuals and for businesses -- will prove hard to define. Under the leading Senate proposal, employers might be incentivized not to hire workers from low-income families. And the public option will remain controversial. It's too early to say whether Obama was successful in shifting the onus of responsibility onto Republicans. But by calming down his own party -- without alienating moderates -- and by making a moral case for health care, he has unsettled the status quo. |