Balancing Obama challenges critics, outlines goals

EVEN Phillipe Petit - the acrobat who stunned the world 35 years ago by walking a tightrope between the towers of the World Trade Center - might have been intimidated by the balancing act that President Obama tried out last night.

Consider the tricky and narrow middle path that Obama staked out last night in urging Congress to pass a sweeping health-care reform package, in what has become the epic struggle defining the first year of his presidency:

The president posed an unexpected challenge to Republicans who so far have engaged in lockstep resistance to Democratic reform ideas - but not so much by criticizing GOP ideas as embracing a few of them and then daring those same Republican lawmakers to get on board.

But at the same time, Obama sought to appease his weary liberal base by endorsing in strong words the notion of a government-run, lower-cost health-insurance option - even as his broader message suggested that the public option is dead for now.

And rather than avoid the ugly political tone of an American summer that will be remembered for heated town-hall meetings and sometimes passionate but often irrational charges and countercharges, Obama's strongest words of the night took on the nation's dark mood directly.

"But what we have also seen in these last months is the same partisan spectacle that only hardens the disdain many Americans have toward their own government," Obama said in his second address to a joint session of Congress. "Instead of honest debate, we have seen scare tactics. Some have dug into unyielding ideological camps that offer no hope of compromise."

Indeed, the president took the surprising step of tackling some of what advocates consider misinformation that swirled this summer rather than ignoring it. He attempted to shame claims by Republican pols that his plan included what they called "death panels" for senior citizens as "laughable" if it were not so "cynical." "It is a lie, plain and simple," Obama said.

But the night offered a jarring and arguably shocking reminder of the gap that the president was seeking to bridge, when someone from the GOP side of the House chamber shouted "You lie!" when Obama said his plan didn't cover illegal immigrants amid boos from Republicans. The Associated Press reported that it was South Carolina Rep. Joe Wilson.

When the shouting was done, the ultimate goal, it seemed, of Obama's needle-threading last night was this: To craft and lay out a bill that would avoid a lethal filibuster and get exactly 60 Senate votes, which would include at least one Republican - and quite possibly no more.

To achieve that, Obama - who has been content until now to let Congress hash out a plan to insure more Americans while lowering medical costs - finally put most of his cards on the table. Arguably, the president's delay in unveiling details allowed him to gauge what might actually pass Congress in the heated, partisan climate.

And so the centerpiece was not the controversial "public option" - government health insurance that has been long sought by liberal Democrats - although Obama did insist that he still wants such a plan, even if he didn't mandate one. He urged progressive Democrats to be flexible on the issue.

However, the White House seemed to hedge its bets and acknowledge reality by also proposing what it called a new kind of nonpublic insurance marketplace called The Exchange, which would come online in 2013. Until then, Obama proposed, a national "high-risk pool" would provide insurance for patients with pre-existing medical conditions.

Jonathan Cohn of the New Republic - author of "Sick: The Untold Story of America's Health Care Crisis and the People Who Pay the Price" - blogged last night that the most significant news was a call for an individual mandate requiring Americans to purchase health insurance.

Added Cohn: "The tone is pretty striking, too. Obama reaches out to Republicans in several places. But he also comes down hard - very hard - on opponents who are merely out to defeat reform."

But Republicans - including Louisiana Rep. Charles Boustany Jr., a heart surgeon, who delivered the televised response - continued to hold to the position that the GOP doesn't oppose all reform but wants to restart the tangled process.

"It's clear the American people want health-care reform, but they want their elected leaders to get it right," Boustany said. "It's time to start over on a commonsense, bipartisan plan focused on lowering the cost of health care while improving quality."

Several aspects of Obama's speech seemed aimed at winning Republican support, or at least challenging the GOP politically. Obama even received a standing ovation from the Republican side when he acknowledged the issue of medical-malpractice reform - a pet cause of conservatives - and said he'll ask the Department of Health and Human Services to study programs ending what was referred to as "defensive medicine," which may be unnecessary but is administered to avoid the possibility of a lawsuit.

But at the libertarian Cato Institute think tank, Patrick Basham blogged that it was a "strikingly political/partisan rather than statesmanlike speech. Obama chose to pressure Republicans to support his plan rather than attempt to persuade them to do so."

Other highlights of the Obama administration's plan include measures aimed at those who already have private insurance, including a provision aimed at preventing insurers from dropping customers when they get sick.

But the tone was as memorable as the substance.

Obama, who at times is compared with the "Star Trek" character of Spock because of his measured tones and his frequent appeals to logic, tried a more emotional tone last night. With Victoria Reggie Kennedy, the widow of lifelong national health-care advocate Sen. Ted Kennedy, seated prominently in the House gallery, Obama spoke passionately of cancer patients who were stripped of their health insurance and suffered or died as a result.

"That is heartbreaking, it is wrong, and no one should be treated that way in the United States of America," Obama said to thunderous applause.

He closed the speech by reading from a letter that Ted Kennedy sent him to be read after he died, in which the Massachusetts Democrat called health-care reform a matter of the "fundamental principles of social justice and the character of our country."

Obama added his own defense of liberalism - "[a] belief that in this country, hard work and responsibility should be rewarded by some measure of security and fair play; and an acknowledgment that sometimes government has to step in to help deliver on that promise."