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A Passionate Appeal to Salvage the Impossible

Parts political reprimand and parts pragmatic entreaty, President Obama on Wednesday urged congressional lawmakers from both parties to put away the partisan bickering for the sake of salvaging a plan for health reform this year.

Appearing before a joint session of Congress for the first time since February, Obama at turns laid out the specific elements he’d like to see in a reform bill, reminded Congress of the urgency in overhauling the nation’s broken and unsustainable health care system, and went after lawmakers for turning the debate into a “partisan spectacle that only hardens the disdain many Americans have toward their own government.”

“The time for bickering is over,” he said. “The time for games has passed. Now is the season for action. Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do. Now is the time to deliver on health care.”

Early signs, however, indicate that the Republicans are ready to continue fighting the Democrats’ plans. When Obama took on the GOP myth that the Democrats’ proposal would cover illegal immigrants, for example, Rep. Joe Wilson (R-S.C.) screamed, “You lie!” Responding for the GOP afterward, Rep. Charles Boustany (R-La.), a physician who’s accepted more than $1.2 million from health and insurance interests in the past five years, blasted the president’s vision with the popular conservative criticism that it proposes a government takeover of the nation’s health care system. And, most importantly, Sen. Olympia Snowe (R-Maine), an influential member of the Gang of Six, issued a statement afterward saying she “would have preferred that the [public plan] were taken off the table.”

“Any bill with a public option will not pass the Senate,” Snowe said, “and this divisive subject is unnecessarily delaying our ability to reach common ground.”

The comments are emblematic of just how difficult it is to get health care reform legislation through the sea of special interests — and special interest lawmakers — that practically define Washington in the modern era. Indeed, not only was Obama appealing to congressional lawmakers, but any reform efforts will also have to receive at least the partial blessing from the nation’s doctors, nurses, hospitals, drug makers, insurers, medical device makers, clinical labs, nursing homes, pharmacists, home-care specialists and all the other stakeholders in what has evolved into the $2.6 trillion-per-year medical industrial complex. This does nothing to mention the patient advocates and state governors who also want their say.

Obama’s $900 billion strategy for health reform — his most specific since last year’s campaign — picks from the various proposals that lawmakers of various stripes have been pitching around the Capitol for months. There was something there for everyone. For liberals, for example, Obama is pushing for the creation of a public insurance plan to compete against private insurers in hopes of keeping premium costs, which have soared in recent years, affordable. “Consumers do better when there’s choice and competition,” he said.

Yet he drew no lines in the sand on the issue, insisting that he’s willing to “explore” compromise proposals — including private health cooperatives and trigger systems that would launch regional public plans only if private insurers failed to meet certain cost and coverage targets — as long as there is some assurance that an affordable option is available to everyone.

For Republicans, he tossed a peace offering in the form of the promise to explore tort reform through state-based demonstration projects — a proposal long-popular among conservatives, who argue that the threat of frivolous lawsuits forces doctors to order more tests and treatments than they otherwise might, thereby increasing the nation’s health care costs.

Obama certainly didn’t back down from his previous criticisms of private insurers, attacking the industry for hiking premiums, denying coverage for preexisting conditions, and dropping coverage when patients get sick. In line with the proposal floated this week by Senate Finance Chairman Max Baucus (D-Mont.), Obama proposed a fee on insurance companies “for their most expensive policies.” Yet he also made clear that he doesn’t want to put the private insurers out of business, as many Republicans claim is the ultimate goal of the public option. “They provide a legitimate service, and employ a lot of our friends and neighbors,” he said. “I just want to hold them accountable.”

Obama also tackled head-on the myths that the Democrats’ plans would promote abortion, cover illegal immigrants, steal Medicare dollars from seniors and empower the government to euthanize grandma, as some Republicans have charged. Of the death panel claim, Obama said the accusation “would be laughable if it weren’t so cynical and irresponsible.”

“It is a lie, plain and simple,” he added.

To address costs — and to appease Republicans — the president vowed that the reforms be deficit neutral, going so far as to propose language to cut future spending if projected savings didn’t materialize.

Finally, Obama also vowed to pass a bill this year, declaring that he’s “not the first president to take up this cause, but I am determined to be the last.”

Obama ended with a passionate challenge to Congress not to do the politically easy thing and “kick the can down the road” to future Congresses. “We can act even when it’s hard,” he said. “That is our calling. That is our character.”

The challenge has been laid. It’s up to Congress — particularly Republicans — to decide whether to meet it.

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