Obama Claims Middle Ground on Health

In an effort to regain the momentum on health care reform, President Barack Obama gave a very good speech to the Congress yesterday.

I liked three aspects of it in particular. First, it had passion. Obama made the moral case for universal health care that liberals have been waiting for. He quoted a letter from the late Senator Ted Kennedy that asserted that health care goes to “the character of our country”. The president’s remarks contained good lines and moving stories, including that of the Illinois man who lost his health insurance coverage during chemotherapy because he hadn’t reported gallstones that he hadn’t known about. It is remarkable that the most powerful country in the world is also the only advanced democracy to leave so many citizens uninsured.

Second, the speech showed strength. My principal criticism of Obama’s presidency so far has been his unwillingness to wade into debates, whether domestic or international, and use leverage and pressure to enforce his will.

He has remained reasonably aloof from the health care issue for months, but with this speech he stepped right in. He showed the Congress the face of presidential authority. He named and refuted the extreme claims made by opponents of reform. He promised to leave the door open to dialogue, but warned “I will not waste time with those who have made the calculation that it’s better politics to kill this plan than to approve it.” “If you misrepresent what’s in this plan”, he promised, “we will call you out.” It’s about time Obama showed there are costs to opposing his program.

Finally, and most importantly, the speech claimed the middle ground. He threw in some red meat for liberals (health care would cost less than the Iraq war!), but his real targets were congressional centrists and their constituents. He reached out to Republicans, calling in aid Theodore Roosevelt and John McCain. He reminded listeners that the differences between the two sides were not as great as it often appears. He made the vital argument that reform would help not only the uninsured but also the 90% of Americans who have insurance already, by describing the huge and growing budgetary burden imposed by the current system and reminding Americans that if they lose their job they can lose their insurance.

At the heart of Obama’s argument was this plan:

• Improve current health insurance by requiring insurers to cover people even if they have a pre-existing condition, preventing them from dropping people when they get sick, and capping out-of-pocket expenses on the ground that ‘in the United States of America, no one should go broke because they get sick’;
• Provide stopgap coverage to those with pre-existing conditions;
• Establish an insurance exchange, featuring a not-for-profit ‘public option’;
• Require that everyone be covered; and
• Do all this without adding to the deficit.

The president’s dive for the centre got a nice push from the graceless interjections of “you lie” from South Carolina Congressman Joe Wilson. This would have been considered unparliamentary language even in the NSW Parliament, and the Americans are much more sensitive to this kind of thing that we are – especially when it’s thrown at the President. I doubt Obama will be too worried, though: in fact he should send the guy flowers. Throughout his career, Obama has often been fortunate in his enemies, and so it proved again yesterday. Wilson’s fellow Republicans will not thank him for tarring them with his behaviour.

In my review of Obama’s Cairo speech for The Punch, I noted that he ended with a nod to his predecessor President John Kennedy’s Inaugural Address. I think there’s another JFK reference in yesterday’s speech. Shortly after describing the letter he received from Ted Kennedy, and after describing the efforts of past American politicians to extend the reach of health care, Obama said:

“We did not come (to Washington) to fear the future. We came here to shape it. I still believe we can act even when it’s hard.”

It’s difficult not to read this as a reference to President Kennedy’s speech to Rice University in 1962 about the space race, in which he famously said:

“We choose to go to the moon. We choose to go to the moon in this decade and do the other things, not because they are easy, but because they are hard”.

In the United States, reforming health care is never easy. It will still be hard for Obama and his allies to pass a reasonable reform bill, but the president’s speech to the Congress edges them closer to that goal.