On health care, Obama as prosecutor in chief

Howard Fineman • E-mail

WASHINGTON - The president has become a prosecutor.

Politically, that’s the news that emerged from Obama’s speech to Congress Wednesday night.

The transformation came just in the nick of time to revive (although not completely) his wobbly effort to sell a massive change in the way this country delivers health care.

Barack Obama is a lawyer, but he has rarely been in a courtroom, let alone passionately argued a case in one. Too often, he sounds more like a law professor or a writer than an advocate. While he closed last night with an eloquent, philosophical defense of the fail-safe role of government, the bulk of his speech was a stirring, accusatory statement of a plaintiff’s case.

It was, as he styled it, People v. The Insurance Company and Bad Republicans. For the most part, his tone and language was mild, as usual. But the content was crystal clear: He had enemies to name, and names to call, and Obama did both.

Even as the president complained about the lack of civility in public discourse — a complaint many Republicans had to have found annoying — Obama tore into insurance companies. He recounted anecdotes of their (alleged) cold-hearted rapaciousness and obsession with the bottom line.

As Obama described it — and as many Americans have experienced it — insurance companies are far too quick to cut off coverage, to raise rates, and to deny access to those with pre-existing conditions. In short, when you need health insurance most, you lose it or can’t get it. And if you can get it, it costs too much.

He dares health insurance firms to respond
Taking a page from Teddy Roosevelt, the president rhetorically busted the trusts, or promised to, by suggesting that his reform plan would rein in the worst insurance company abuses.

He all but dared the health-insurance industry to respond. They have been spending money, but quietly. He called them out.

This was Obama finally internalizing and acting on the counsel of his campaign pollster, Joel Benenson, whose advice all along has been simple: attack the insurance companies.

This is an accusatory, laser focus that has been missing from previous Obama summaries, and there were tactical reasons for it. In politics, you need an enemy, and now he has one. Also the new tone will thrill, if not fully pacify, the left wing of his party, which is likely to be disappointed by the lack of a sweeping “public option” in the final bill.

Obama took on the GOP, too — even as they sat there alternately cheering and jeering him. There were good Republicans, he said solemnly, people like John McCain and Orrin Hatch and even President George W. Bush. But there were bad, BAD Republicans who were spreading lies about his plan, its design and its details, and he was not going to put up with it.

In better shape?
Even though his personal popularity has plummeted in the polls, even though criticism has grown of his performance on health care, the president and his aides have insisted that they are in better shape than the carping pundits know.

Obama’s health care plan President Barack Obama’s health care proposal would: • Allow Americans to keep their current coverage if they wish. • Create an “insurance exchange” that would allow individuals and small businesses to bargain for insurance collectively. • Bar insurance companies from denying coverage because of a pre-existing condition. • Prohibit annual and lifetime caps on the coverage recipients can receive. • Impose limits on out-of-pocket expenses. • Require free coverage for routine checkups and preventive care. Source: The White House

And I think maybe Obama is right, even as messy as this is right now.

Few if any Republicans will be players in this game from here on in. This is almost entirely a Democrats-only game now.

Obama is going to keep talking about the public option: Without showing some commitment to it, there is no way he can get Democrats in the House to vote for one bill later this month. But he won’t fully commit to the idea, in hopes of getting at least one Senate Republican, Olympia Snowe, to come on board.

Obama’s invocation of the memory of Ted Kennedy was not unexpected, though the exact content of it was — a posthumous letter. Close ups of the senator’s teary-eyed widow were emotional arrows aimed directly at the hearts of core Democrats, whose loyalty the Obama White House desperately needs.

All in all, Obama’s address showed a tough-minded commitment to political combat — at turns accusatory, emotional, and, in his final lecture on the role of government, eloquently philosophical.

It was one of the best speeches he’s given — which is saying something. More importantly, it was one of the most useful.

There is still a long way to go — votes and conferences and more votes. But the president did a lot to help his cause by (finally) arguing his case.

More on: Health care

More from msnbc.com World Blog: Bracing for climate-change migrants   Bank bailout will cost taxpayers billions Red Tape: Times are tough — even for cybercriminals    Brazilian police accused of killing 11,000 since 2003   Send us your salutes to troops, friends, kin Giving back for the holiday season? Tell us how On Twitter: Breaking news updates | Weird and wild

MORE FROM HEALTH CARE

Health care Section Front

U.S. tops world in health spending, results lag Senate rejects tougher abortion measures Senate votes on Medicare in Saturday session Deals cut on health bill may be at peril Surgeon general wants more minority docs Medicare cuts stay in Senate's health care bill Poll: Most in U.S. want public health option AARP backs Dems in Senate health care fight Breast-screening debate splits along party lines Orszag: Health efficiencies could take 'decades' Health care Section Front   Add Health care headlines to your news reader: