President Barack Obama's health-care speech to the Congress Wednesday night was delivered effectively and the watching national audience likely will likely give Obama, and his handling of health care, a short-term jump in public approval. Within the Congress, where the substantive issue will be decided, greater polarization will take place. Obama took several rhetorical swipes at Republicans which will have the net effect of hardening their opposition to bamaCare.
Moderate, Blue Dog Democrats in the House, principally concerned with the costs of the prospective health package, may have been heartened by his apparent toss overboard of the "public option" — a government entity to compete with private health insurers — but will remain worried by his promise that the package's estimated $900 billlion cost will be met largely through undefined savings in Medicare. The latter also will alarm senior citizens dependent on Medicare. Obama's suggestion of pilot experiments in tort reform will not be sufficient to attract tort-reform proponents to ObamaCare.
Liberal House Democrats were reinforced by Obama's forcefulness and swipes at the opposition. But they, labor unions, and other proponents of a public option will be less enthusiastic about the overall legislation because of Obama's willingness to abandon the option. Liberals have nowhere else to go, however, and in the end will vote overwhelmingly for final legislation.
Practical Senate Democrats will be heartened by Obama's message on the public option because, it had become apparent, no legislation could pass the Senate containing such a provision. Legislation expected from the Finance Committee later this month will no doubt omit the provision. Insurance and drug companies are now more likely to resist legislation because of being singled out by Obama for reproof and targeted as revenue sources for ObamaCare.
Surveys have consistently shown citizens to be more greatly concerned with rising federal deficits than with designing a health-sector remake. Obama promised Wednesday night that he would sign no plan increasing federal deficits. At the same time he proposed major expansions of health-care coverage, involving major increases in health-care costs, not consistent with a zero effect on the federal budget.
The large and central question in debate from this point forward: How, specifically will $900 billlion be found to pay for the plan? How much from removing "waste and abuse" from Medicare and Medicaid and how much from higher taxes and fees on whom?