And the president speaks. As expected, he focused on reform from the point of view of the payer — focusing on ending some practices from payers on which the majority of patients, regardless of where they fall on the political spectrum, more than likely agree. Tactics such as prohibiting coverage due to pre-existing conditions; utilization of tax subsidies to finance care for the working poor (a nod to what John McCain proposed as the president’s 2008 election opponent); and an effort to end discriminatory practices in the formulation of risk pools. In other words, he played it safe.

Not to be mistaken, the president reiterated his support for a public option. But it was mostly a gesture to retain his posture within his party, eschewing the great concern among Democrats that he had veered to close to the center on this issue (as many feared he would completely nix the option — at least in theory). If anything, the proverbial “line in the sand” is probably deeper between parties after his address tonight. His threat to “call out” politicians on the Hill who continue to “play politics” with pending reform legislation was meant to challenge Republicans to reach his much sought-after “common ground”.

Instead, he may have alienated them. Will the Democrats have to go it alone? Will Finance Cmte. chair Max Baucus (D-MT) really come through on his promise to formulate a reform framework [PDF] on his own next week? Instead of answering questions, President Obama’s reform address — while slightly more forthcoming with details — leaves many asking them,^[1] instead.

1. Will there ever be any bipartisan agreement on how to reform any other aspect other than insurance reform? Or, should Insurance have to solely shoulder the cost by finding ways to pay for reform, saving gov’t entitlements like Medicare from additional future costs, as Obama suggests? [↩]

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