Obama's Health Care Pitch Needs Work

Washington Matters

Obama's Health Care Pitch Needs Work

President Obama didn't hit the home run last night that health care overhaul advocates needed to ensure an agreement on national reform. The prime time address and news conference was not an impassioned or dramatic call to arms. Instead, Obama straddled many key issues in the ever complicated debate, and that can look like a salesman unsure of his product.

His main talking points were strategically smart, even if a little defensive sounding, and he carefully left several doors open for compromise, including on whether a final plan will have an individual mandate, a tax on employer provided benefits, a requirement for employers to provide coverage and the specifics on a public-provider option. The complexities and lack of clear detail ensure no final action by Congress in the very near term. It certainly ensures a longer sales effort, including Obama's trip today to the Cleveland Health Clinic, where he'll highlight cost reduction successes.

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It was notable that Obama barely discussed a public provider option, considered by many a central pillar but also a flash point with critics. He also mentioned a "health insurance exchange" but did not provide any definition or elaborate. 

His challenge will be to keep momentum from stalling over August. He might have done well to insist Congress stay in session and skip its recess. It's clear anyhow that months more work will be needed to shore up public support. He made some progress on that last night with direct criticism of big, faceless and largely unloved insurance providers, noting how profits are way up, premiums keep rising and health care quality and access is eroding.


He repeated several times that without large changes, health care will get worse and cost employers and employees more and drive up the long term deficit, and he chose well in aiming to speak directly to the large majority of Americans with health care, many of whom are uncertain that a major overhaul is truly needed and worry that it will leave them with less than they have now. Also unclear as yet is whether overhaul will significantly lower out of pocket expenses. That has to be the clincher, as it's already becoming a top GOP talking point

Another challenge for Democrats will be facing down Republican charges that an overhaul will cost far too much. Obama took some steps last night, saying two-thirds of the cost could be found in reallocating federal health money already in the system that he claims is wasted. The remaining third, which could amount to several hundred billion dollars, remains a question mark.

Obama looked to be in a bit of a corner last night, needing to keep a diverse coalition together and carefully encouraging a sometimes skeptical public, as well as conservatives in his own party. Most Republicans look certain to oppose a Democratic plan, although some moderate Republicans will be key in negotiations and will help prospects this fall.  

Odds are still fair to good for some agreement this year. The scope will be unclear for a while but it could be a final package is scaled back to something simply easier to pass and much less expensive. But even that assumes that Obama's sales pitch is perfected and a sense of economic and social urgency about reform takes tighter hold.