"...Insurers should be prohibited from denying coverage or charging exorbitant rates for pre-existing conditions and from imposing annual and lifetime limits on benefits. Stronger consumer protections should be enacted. And a virtual shopping mall with more private health plan choices should be created so that consumers compare prices, benefits and quality, and then pick the plan that's best for them. Top actuaries and the Congressional Budget Office have said that making plans compete will keep premiums lower and increase affordability for everyone."
The remarks I've pasted are the essence of the president's health care plan. And yet these words were not uttered Wednesday night by President Obama. They were, in fact, spoken by Sen. Chuck Grassley (R-Iowa), who has become the face of opposition to the Democrats' health care legislation in the Senate.
So here's the bottom line: The president became an advocate for a plan that Congress, in effect, has agreed to. This isn't ledgermain: Mr. Obama promised as much during the campaign, and Democrats, for years, have been fighting for many of these reforms. And the irony is that these changes to the American health care system are popular.
So why are we even here?
The president was dealt a tough hand when he got into office, no doubt, but the debate about health care managed to make majoritarian proposals sound like the type of liberal social engineering that wouldn't be prudent amid a deep recession.
At the same time, the president's willingness to work with the insurance companies, the hospital and doctors' lobby and the pharmaceutical industry have raised suspicion among the left about the president's motives. Many liberals came to view the agreed-upon proposals as inherently suspect because of who it was that was doing the disagreeing.
CBSNews.com Special Report: Health Care
One popular proposal -- adding a government-funded plan to the menu of options for those lacking insurance -- became the Mason-Dixon line for many progressives. Cross it, and you're with the enemy. The White House, determined to let Congress fill in the blanks and work out the details, lost control of how the basic, popular reform package was communicated.
Ah, so here we are.
A presidential address has many audiences, but the president tonight was focusing on people who have leverage: House Democrats who seem willing to jettison the largest expansion of government health care since Medicare because the Senate can't vote for a non-for-profit public option available in the insurance exchange; those few Senate Republicans who have been willing to consider a bill that was written by Democrats in an era of Democratic government; and political independents, a plurality of whom are skeptical, today, of health care reform, but for whom the degree of partisanship associated with a particular position often determines how much -- or little -- they support it.
No mistaking the president's tone: he reached across the aisle, name-checking Republicans who contributed to the bill (John McCain, Orrin Hatch, George Bush, even Grassley), but he was explicit in condemning those who are participating in the debate only to defeat reform.
For the liberals, there were carrots and sticks, although more of the former. Mr. Obama explicitly endorsed an individual mandate. He defended the essence of the public plan. He linked this moment in history to the broader narrative that has animated progressives for decades: "Hard work and responsibility should be rewarded by some measure of fair play and that sometimes, government has to step in and deliver on that promise." Health care is a social responsibility.
So will this sales job work?
I think, among liberal, the answer is almost certainly: yes, more because of the president's style rather than the specifics of his proposal -- The end of his speech, where he invoked Ted Kennedy's vision and called it a moral imperative for the nation; The middle of the speech, where he castigated opponents as defenders of the unworkable status quo; at the beginning of the speech, where he outlined the fundamental stakes of the issue; And because of two words, from Rep. Joe Wilson (R-S.C.), who called out "you lie," when Mr. Obama said that the Democratic bills wouldn't provide coverage for illegal immigrants. This was inaccurate and was churlish.
Full CBSNews.com coverage of the president's speech on health care:
Obama Tells Congress to Stop Bickering
Full Video Full Transcript Speech Highlights
GOP Response: "It's Time to Start Over"
Marc Ambinder: Will Obama's Sales Job Work?
Mark Knoller: Obama Willing to Compromise - Up to a Point
Was Obama Clear on the Public Option?
Ted Kennedy's Letter to Obama
Rep. Wilson Apologizes for Obama Speech Outburst
Analysis: The Road Ahead for Health Care
From the perspective of the president, there is hard work yet to do.
For one thing, independents are still skeptical, although I suspect that those who watched the speech will be comforted somewhat. Before the speech, Republicans were more enthusiastic about defeating the plan than Democrats were about supporting it.
The president's performance tonight will probably buck up liberals, which will have the paradoxical effect of further hardening the spines of conservatives, which might well mean that we're in for a period of poisonous political exchanges. (The partisanship of July and August is one reason why health care reform is more popular in its parts than in its sum.)
And make no mistake: the details that have yet to be worked out (members chuckled when Mr. 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 Mr. 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.