Is This a Preview of Obama's Health Care Speech?

When President Obama began the health care portion of his Labor Day speech in Ohio today, he prefaced it with the words, “I'll have a lot more to say about this Wednesday night, and I don't want to give it all away.” Still, it’s hard not to imagine that the themes, if not the words themselves, will be heard on Wednesday night. And if so, we’ve already seen the main thing Obama wants to bring to the discussion: vision.

The problem with any legislative debate is that the leaves often obscure the forest. With health care, we have spent so much time debating what is an appropriate level of income at which to cut off subsidies for those who cannot afford insurance, that we neglect to talk about how eliminating the uninsured will benefit insured and uninsured alike. The disruptions and the torpor of the past month have been even worse. Someone handed me a flier that had been distributed by staff at a pro-reform Congressman’s town hall. Every bullet point began with, “Health reform will NOT.” They hit all the same easily disproven talking points you’ve heard: killing grandma; illegal aliens; abortion; cutting Medicare benefits; the whole kit and caboodle. Necessary, but also defensive.

So too, in retrospect, was Obama’s June and July argument that there are two choices -- heath care costs continue spiraling out of control and leaving more and more people behind, or we finally fix it for everyone. True, but also defensive against the notion that the status quo is sustainable, that reform is a choice, not a necessity. For months, defenders in Washington have been trying to tell you what reform is not, rather than what it is.

Based on today’s speech, expect Obama to spend time painting a picture. Every section of the 700 or so words on health care begins with the refrain, “I see…”, a trick FDR’s speechwriters employed again and again when proposing new programs with moral force. (In fairness, they also stole it from some 19th century speechwriters). Health care will be about “stability and security to folks who have insurance today.” It will be about how “Americans and small businesses that are shut out of health insurance today will be able to purchase coverage at a price they can afford.” It will be about reform that will “protect our senior citizens” by closing the doughnut hole in Medicare’s prescription drug program and putting Medicare on sounder financial footing. It will be about “a health insurance system that works as well for the American people as it does for the insurance industry.” These are the elements that, generally, we’re not talking about when we tackle mythbusting, or talk about “bending the curve.” We don’t even talk about them when we’re discussing co-ops or triggers for the public option or even bipartisanship.

If we’re going to win reform this year, we need to start talking about them again. I’m very skeptical that a presidential address will do it. It might restart momentum in the legislative process -- which is all it needs to do -- but even a speech from such an accomplished orator is unlikely to change the tenor of the public debate after all this time. But damned if it isn’t worth a shot.

(Photo credit: Official White House Photostream on Flickr.)