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

Passion and strength: Obama has seized control of the health reform debate.

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.

- Michael Fullilove is the director of the global issues program at the Lowy Institute in Sydney and a nonresident senior fellow at the Brookings Institution in Washington, DC.

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    • Eric says:

      05:16pm | 11/09/09

      Yawn. Obama’s speech was beaten in the ratings by a reality show. Not much of a surprise because Obama’s delusions can’t compete with reality.

      The most divisive president in a century is rapidly losing what little credibility he had, and pushing his partisan rhetoric on every TV station will only make people tire of him faster.

      As for Joe Wilson, good on him for speaking truth to power! Someone had to say it.

    • Richard of brissy says:

      06:57pm | 11/09/09

      Obama like Krudd the DUDD is ALL SPIN and no substance, only the people who want to keep their noses in the money trough still think they are popular and when all the money runs out and everybody has to make the repayments then these same people will scream the loudest and both these idiots will be long gone

    • Richard Ure says:

      07:19pm | 11/09/09

      For an allegedly modern country, Americans can be unbelievably backward. It is such fun watching them thrash around to sort out their health care mess and to see Rupert Murdoch’s mouthpieces play their role in holding back the obvious reforms. The power of lobby groups and vested interests is wondrous to behold. And the people being screwed support them.

      I have read a fair bit of US commentary on this issue but have not seen any discussion on how they might go about reducing the cost side of the equation (beyond reducing the horrendous administrative costs of denying claims). I can’t imagine then contemplating the concept of the most common fee. Or organising the solution on a federal basis. Will there be a PBS? And why are “aliens” excluded? Don’t they pay even indirect taxes?

      Enjoy the tortured logic of the Wall Street Journal’s response to Obama’s speech to the Joint Sitting.

      And the “right” to drive? Even when the oil dries up?

    • james scully says:

      07:20pm | 11/09/09

      Eric. What a stupid comment you made.  Your bias is disgusting. All he was asking for was for some commonsence on the issue. I read some of the remarks penned by the loony right in America on this healthcare issue. They were beyond the pale! A friend of mine has lived and worked in America for years and the cost of private healthcare is horrendous. Do not fall ill if you are poor in America. God help us from nutters like you Eric.

    • Razor says:

      10:37pm | 11/09/09

      The sentiment is lovely.

      The reality is much more ugly.  Could an Obama supporter please explain how an insurance company will be forced to “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” without increasing premiums.  Anybody who has a basic understanding of insurance underwritingknows that increasing risk and quantum requires increased reserves and premiums.

      The lofty ideals are lovely but how is it going to actually work and how much will it cost?

    • Richard Ure says:

      11:40pm | 11/09/09

      Razor: For some reality, look no further than With a single basic health care insurer covering EVERYONE, it works and we have lots of experience to prove it.

      Americans can’t be persuaded there are some things (apart from the military) properly run governments departments can provide better than the private sector. And because they don’t expect it, they don’t get it.

      It is interesting to observe Americans are terrified of “big government” whereas in France (and to a certain extent, Australia) governments are afraid of the people.

    • Eric says:

      08:46am | 12/09/09

      Americans could have a better health care system—but not if it’s the one Obama proposes. His bloated monster with its pandering to lawyers and pharmaceutical companies would only make things worse, at the expense of further burdening an already debt-ridden economy.

      If Obama was sincere, he’d compromise with the Republicans on reform—but instead, he is just trying to push through yet another big-spending bill to reward his political cronies.

    • RobJ says:

      08:51am | 12/09/09

      “And because they don’t expect it, they don’t get it.”

      But who can blame them when high profile Republicans (Palin?) are telling them blatant lies? You know, they freak out at the term ‘socialism’ but I bet most Americans attend public schools, they all use public roads. Access to education and transport are fundamental requirements IMO, but so is health care.

      Fact is Americans spend more on health care than say Australians but Australians have better health cover (and most Europeans enjoy more accessible health care too)

    • RobJ says:

      08:59am | 12/09/09

      “The most divisive president in a century is rapidly losing what little credibility he had, “

      He’s only divisive because unfortunately many Americans believe the utter lies about things like ‘death panels’ and stories that the likes of the brilliant Stephen Hawking would be snuffed out by a public health system, even though Hawking himself claims he wouldn’t be alive without the NHS. It seems to me that it’s the Republicans being divisive (what a surprise - “you’re either with us or you’re with the terrorists” Who said that???)

      “pushing his partisan rhetoric”

      Like ‘Death Panels’? Are you serious?

      “As for Joe Wilson, good on him for speaking truth “

      I guess you’ve been sucked in by the lies. What a shame so many Americans believe this rubbish, pretty much condemning millions of their countrymen to a lack of adequate health care. It’s more than a shame, it’s a disgrace!

    • Dude says:

      10:30am | 12/09/09

      The first thing the Yanks should do after health care reform is locked down, is to work on a cure for rightardation. The best way to cure it though is to bring the education system into the 21st century and out of the 19th. Why are the right so ignorant in so many ways? It can’t be just fear and genetics. What an embassment they are to themselves and the human race .

    • Chris says:

      10:49am | 12/09/09

      Anyone who thinks Kevin Rudd is scared of the people is a fool, he treats us all with complete contempt.

      And Obama looks more like just another bag of hot air with every passing day, he like Rudd is deeply partisan and only interested in keeping his snout in the trough. The Democrats will do nothing to reduce costs because their own constituents (lawyers) are the ones driving up the cost of health care in the US.

    • RobJ says:

      11:38am | 12/09/09

      ” he’d compromise with the Republicans on reform”

      He said he would deal with the progressives but seriously Eric, why would anybody attempt to deal with the nutters who tell ridiculous lies, how is one supposed to deal with those?

    • Razor says:

      02:53pm | 12/09/09

      Richard Ure - I was not asking how the goverment can do this.

      I want to know how Insurance Companies will be able to do what is being proposed.

      Perhaps Mr Fullilove (isn’t he - for The One) could explain seeing he reckons it is such a great idea.

    • Richard Ure says:

      05:04pm | 12/09/09

      Eric: What sort of compromise do you have in mind? So far all the Republications seem to be saying is: “No”. To everything. If their scare campaign wasn’t so extreme, it might be possible to have a sensible conversation. Will they only be happy as long as it is business as usual for the insurers and the drug companies?

      Just as it is with the Israelis and the Palestinians, it is impossible for both sides to have everything. How do the Republicans plan to solve ANY of the obvious shortcomings of the current system? In many cases it seems even the insured can miss out. How can that be acceptable?

    • Eric says:

      06:27pm | 12/09/09

      RobJ, you exemplify the ultra-partisan spirit of divisiveness and hatred that will prevent any meaningful solution being reached.

      Richard Ure, the Republicans have their own proposals, which have been ignored by the Democratic Party and their media lackeys. Look them up.

      Obama’s determination to force an uncompromising bill that will increase the already unsustainable debt is purely destructive. His slandering of the opposition as “liars” and “bickerers” “playing games” prevents any possibility of reasonable negotiation.

      Fortunately, Obama’s incompetence and intransigent attitude have resulted in a massive loss of public confidence and support. With any luck, he will be unable to complete his nasty agenda, and may well be thrown out at the next election.

    • RobJ says:

      07:48am | 13/09/09

      “RobJ, you exemplify the ultra-partisan spirit of divisiveness and hatred that will prevent any meaningful solution being reached.”

      “Obama’s delusions can’t compete with reality.” (would that be Palin’s reality ?)

      As for Joe Wilson, good on him for speaking truth to power! (I’m the partisan one???)

      “and pushing his partisan rhetoric on every TV station will only make people tire of him faster.”

      “nasty agenda” (LOL - so nasty hey, wanting all Americans to be able to access health care, what a monster!)

      “purely destructive”

      You’re like a broken record, I would suggest that those telling lies about ‘death panels’ and Stephen Hawking are the ones demonstrating hatred and divisiveness, after all they must know they are lying? How about you actually post something of substance? Or at least point out which of the FACTS (you know those things the Republicans choose to ignore in this debate, they’d rather spread lies) I have listed are partisan or ‘hatred’? Good luck!

      “slandering of the opposition as “liars” “

      It’s not slander when it’s true, the stuff about death panels and Stephen Hawking were lies, plain and simple, why don’t you understand this?

      “prevents any possibility of reasonable negotiation.”

      He told the Congress he would be happy to deal with the progressives, after all what is the point of dealing with the rusted on Republican right who have already made up their mind and propagated lies? I don’t think you actually heard Obama’s speech, either that or you are being dishonest (and partisan) !

      “Obama’s incompetence “

      No doubt Bush must have driven you crazy if you think Obama is incompetent. Face it Eric you are the partisan poster here!

      One more thing Eric, Americans currently pay more than their Western counterparts for health care and don’t get as much for their money. You are the one who needs to remove the partisan blinkers, not I, I’m not keen on any politician or political party, I’m not partisan, I always call it how I see it.

    • Eric says:

      05:18pm | 13/09/09

      You’re just repeating the same old Democratic Party talking points again, RobJ.

      Meanwhile, today over a million people marched in Washington to protest against Obama’s plans. You can deny all you want, but the truth is getting out there.

    • RobJ says:

      06:41pm | 13/09/09

      “but the truth is getting out there. “

      And you can deny all you want that some Republicans have been overtly dishonest, ie they told out and out lies! What really worries me is the irrational hatred of Obama, do any of these haters actually know what ‘socialism’ means? here’s a clue, Obama isn’t one, left of centre doesn’t occur in the US, though every modern Western Nation enacts socialist policy when it comes to roads, public schools, police service, fire service, army, navy etc etc The nations that extend this thinking to health care generally have higher longevity and SPEND LESS per capita on health care.

      BTW -  Do you care to acknowledge that the stuff said about death panels and Hawking were completely and utterly false? And that the Democratic Party may well be using them as talking points (ie calling out the liars) but they are after all FACTS (kind of superior to the lies that the Republicans have put up as talking points)

      And what of the depictions of Obama as Hitler, Stalin and Lenin?

      Heh, I’m watching the morons on SBS right now. “This administration will bankrupt us” one protester just opined. Well I suppose with the fiscal moron thet preceded him he does have a lot of work, and like he says the current system is UNSUSTAINABLE!

      They chant “you lie You lie” like a broken record.

    • Razor says:

      11:01pm | 13/09/09

      Does anyone want to attempt to answer my query with a factual answer?

    • ihmn says:

      09:53am | 14/09/09

      Eric, the Republicans are hatred personified. They are supported by the same right wing Christian conservatives who walked up to a church and shot a doctor in the head, because they didn’t agree with him. They spread fear to their God-fearing, red-fearing constituents so that nothing ever changes.

      And as far as bipartisanship goes, it is a farce, and both the Republicans and Democrats, ALP and Liberals are as bad as one another.


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