Obama's health care reform speech

Last night, President Obama delivered his speech on health care reform before a joint session of Congress. Finally, a much-needed articulation of his goals for legislation. Here are the key points, as described by the Kansas City Star blog, prime buzz:

• Individuals would be required to carry basic health insurance. Those who can’t afford it would get a hardship waiver.
  
  
• Businesses would be required to offer their workers health care or chip in to help cover the cost. Ninety-five percent of small businesses would be exempt because of their size and narrow profit margin.
  
  
• Medical malpractice reform is not a “silver bullet,” but practicing “defensive medicine” can lead to unnecessary costs; demonstration projects will be reviewed to see what changes to medical malpractice insurance would work best.
  
  
• It would be against the law for insurance companies to deny coverage because of a pre-existing condition.
  
  
• Promised to protect Medicare and reassured the elderly that Medicare funds would not be used to overhaul health care.
  
  
• A public option, or alternative to private insurance, needs to be available to the uninsured to “keep insurance companies honest.”
  
  
• The public option would not be subsidized by taxpayers, but would be self-sufficient and rely on the premiums it collects; the Congressional Budget Office estimates that fewer than 5 percent of Americans would sign up.

As a liberal/progressive who had recently begun to suspect that I was (yet again) being ignored or disregarded by a Democratic president, I can say that this speech did much to reassure. President Obama's support for a public option came across as reasonable, not strident. But he offered an out for those who are dead set against it: come up with an alternative. They can't and won't, of course. So, to me, that means the final bill that is presented to Congress will include a public option.

The President made yet another pitch for bipartisan support, even invoking the name of his opponent in the general election and advocating McCain's plan for low-cost insurance that protects those with "pre-existing conditions" from financial ruin. I doubt that this appeal for bipartisanship will win any Republican votes, though. As I'm sure the President suspects, the Republicans have already made the political calculation that they benefit more by opposing reform than by cooperating. The point of his appeal, I imagine, is to portray the Republicans as intransigent and uncooperative.

Well, something is going to pass Congress, and it will probably be passed with, at most 2 Republican votes (Maine's senators: Olympia Snowe and Susan Collins). The Democrats are a wobbly, cobbled-together coalition --that's just who they are --but they know that they must pass something unless they want to be slaughtered at the polls in 2010.

Hidden behind it all, however, is the more fundamental question: is this really a government for, by, and of the people? Or is it just a tool for corporate titans and robber barons? The bill that the President signs will hold the answer.