What a difference a year makes. This time last year, the state of the overall economy was taking a backseat to the healthcare economy. Yes, that 16 percent of the U.S. GDP that became more important than any other domestic issue rearing its head in late summer ’09.

For President Obama, the drive toward passage of the reform bill meant pulling out all stops in reassuring Congress that, if the following six months were to be an exercise in deliberate bipartisanship, all sides of the debate would have to check party lines at the chamber doors in order to hammer out a solution. Instead, the Dems and GOP dug recalcitrant heels in further. Amid the backdrop of voter angst, characterized by recent explosive townhall meetings, Obama had to do what he usually does best — orate.

On September 9, 2009, the president reiterated his desire for a public option — centering his speech around cutting healthcare costs from all angles: with respect to the payers, consumers, and providers. For Obama, the importance of that night meant trying to convince the public that reform would not lead to increased healthcare costs, but increased efficiency and greater access. Of course, the speech became more famous for another reason.

Fast forward to 2010. September 8, to be exact — when the topic will not be the healthcare economy, but the overall economy. The GOP and the Dems are just as obdurate in their positions as they were last year. The stakes, however, are higher. The balance of power, not simple legislation, is the result. And, while Obama did ultimately get his reform bill passed, the public option was not meant to be — at least not now anyway.

The concessions insurers and Pharma had been expecting, indeed, were realized; and Obama showed the world — at best — tepid leadership in his quest for complete overhaul of healthcare delivery. This year, however, he has something much greater to prove — and the cost of healthcare under reform will likely be influenced more by his leadership style over the next two months than he ever could have imagined his drive for its legislation has shown us thus far in his presidency.

UPDATE: The media are having a field day on the sudden increase in Pres. Obama’s hubris in taking on his detractors during a Labor Day rally in Milwaukee. | LINK

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