Fired-up President demands ‘up-or-down vote’ on health care

FIRED-UP PRESIDENT DEMANDS ‘UP-OR-DOWN VOTE’ ON HEALTH CARE…. Watching President Obama’s speech this afternoon on the way forward on health care reform, I noticed something I haven’t seen from the always-cool chief executive in a while: real passion.

It was unmistakable — this president wasn’t just making the case for reform, he was practically demanding it. Forget any rumors you may have heard about half-measures or additional compromises. President Obama is going all in.

From the outset, the president reminded his audience why the notion of reform being “rammed through” is silly. Referencing last week’s summit, Obama noted:

“This meeting capped off a debate that began with a similar summit nearly one year ago. Since then, every idea has been put on the table. Every argument has been made. Everything there is to say about health care has been said and just about everyone has said it. So now is the time to make a decision about how to finally reform health care so that it works, not just for the insurance companies, but for America’s families and businesses.”

The president noted several areas of agreement with Republicans, and presented his plan as a middle ground between the left (which wants single-payer) and the right (which wants to let insurance companies do as they please).

He also spent some time outlining exactly what his proposal is all about, including the notion that reform would give Americans “more control over their health care,” while building on the existing system. Obama presented his package in three parts: (1) ending insurance company abuses; (2) creating a marketplace for uninsured individuals and small business owners; and (3) bringing down costs. All of this would be paid for, and would bring down the deficit.

At that point, the president started knocking down GOP talking points — forcefully.

Why not go with a step-by-step approach?

“Some also believe that we should instead pursue a piecemeal approach to health insurance reform, where we just tinker around the edges of this challenge for the next few years. Even those who acknowledge the problem of the uninsured say that we can’t afford to help them — which is why the Republican proposal only covers three million uninsured Americans while we cover over 31 million.

“But the problem with that approach is that unless everyone has access to affordable coverage, you can’t prevent insurance companies from denying coverage based on pre-existing conditions; you can’t limit the amount families are forced to pay out of their own pockets; and you don’t do anything about the fact that taxpayers end up subsidizing the uninsured when they’re forced to go to the Emergency Room for care. The fact is, health reform only works if you take care of all these problems at once.”

Why not start over with a blank piece of paper?

“Both during and after last week’s summit, Republicans in Congress insisted that the only acceptable course on health care reform is to start over. But given these honest and substantial differences between the parties about the need to regulate the insurance industry and the need to help millions of middle-class families get insurance, I do not see how another year of negotiations would help. Moreover, the insurance companies aren’t starting over. They are continuing to raise premiums and deny coverage as we speak. For us to start over now could simply lead to delay that could last for another decade or even more. The American people, and the U.S. economy, just can’t wait that long.”

And while the president didn’t use the word “reconciliation” specifically, he did outline a legislative approach that makes sense:

“[N]o matter which approach you favor, I believe the United States Congress owes the American people a final vote on health care reform. We have debated this issue thoroughly, not just for a year, but for decades. Reform has already passed the House with a majority. It has already passed the Senate with a supermajority of sixty votes. And now it deserves the same kind of up-or-down vote that was cast on welfare reform, the Children’s Health Insurance Program, COBRA health coverage for the unemployed, and both Bush tax cuts — all of which had to pass Congress with nothing more than a simple majority.

“I have therefore asked leaders in both of Houses of Congress to finish their work and schedule a vote in the next few weeks. From now until then, I will do everything in my power to make the case for reform. And I urge every American who wants this reform to make their voice heard as well — every family, every business owner, every patient, every doctor, every nurse.”

As for the politics, Obama decided instead to focus on right and wrong.

“In the end, that’s what this debate is about — it’s about the kind of country we want to be. It’s about the millions of lives that would be touched and in some cases saved by making private health insurance more secure and more affordable.

“At stake right now is not just our ability to solve this problem, but our ability to solve any problem. The American people want to know if it’s still possible for Washington to look out for their interests and their future. They are waiting for us to act. They are waiting for us to lead. And as long as I hold this office, I intend to provide that leadership. I don’t know how this plays politically, but I know it’s right.”

This was as combative and aggressive as we’ve seen the president in a while. His tone was defiant and unflinching. He used the word “Republican” 10 times, usually in a negative and critical context. It’s as if the president was actually sincere about his bipartisan outreach, and felt personally insulted by the Republicans’ games.

If Congress was waiting for the Obama to signal his commitment to getting this done, it’s safe to say the president left no doubts.