The health care speech

Following Barack Obama's speech to Congress on health care Wednesday evening, and despite unified opposition from minority Republicans, Democratic congressional leaders said Thursday they expect to pass "reform" legislation within the next few months.

They have the votes; there's little reason to believe they won't.

The better question is what such a bill will look like.

Those hoping the president might pull back from his plan for a massive government takeover, instead offering a truly "bi-partisan" plan which could win GOP support with free-market reforms including an end to expensive state coverage mandates, freedom to buy insurance across state lines, and a "loser pays" regime for medical malpractice lawsuits, didn't get much.

On the contrary, the president ridiculed those who "just this year supported a budget that would essentially have turned Medicare into a privatized voucher program. That will not happen on my watch," he vowed. "I will protect Medicare."

From being put onto any sustainable economic footing, apparently.

The president did mention malpractice reform as a distant possibility, promising to "move forward" on "authorizing demonstration projects in individual states to test these ideas" ... but he held a pretty big hammer over the table where he placed those crumbs, vowing "I will not waste time with those who have made the calculation that it's better politics to kill this plan than to improve it."

There was not much change in the president's umpteenth address on health insurance reform. Most notable was his continued -- and still fantastic -- assertion that "Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan."

While praising Mr. Obama's speech, House Speaker Nancy Pelosi and Senate Majority Leader Harry Reid of Nevada signaled separately that the president may not prevail in his inflexible call for legislation to allow the federal government to sell insurance in competition with private industry.

Sen. Reid said he could be satisfied with establishment of nonprofit cooperatives, along the lines expected to be included in the bill taking shape in the Senate Finance Committee.

Ms. Pelosi, though she has long favored a measure that allows the government to sell insurance, passed up a chance Thursday to say it was a non-negotiable demand.

As long as legislation makes quality health care more accessible and affordable, "We will go forward with that bill," she said.

The problem is not Republican opposition to the government "competing" with private firms. (In fact, since the government would mandate which identical coverages each private firm must offer, and what each private firm could charge, this is a vision of "competition" which could be taken seriously only in some Marxist ivory tower.) Rather, the problem lies in the resistance of "moderate" Democrats with their eyes already on next year's elections.

Mr. Obama continued to insist Wednesday that his approach will not result in higher deficits, vowing again to veto any bill which would have that effect.

But the Congressional Budget Office says Mr. Obama's plan will cost a fortune.

Nevada Rep. Dean Heller offered an amendment in Ways and Means which would have cut off enrollment in the "public option" plan at the maximum number of people who now lack insurance, as determined by the Census Bureau. Democrats defeated that amendment.

If their goal is merely to insure the uninsured, why vote down such a cap? Obviously, Democratic congressmen know the "public option" was planned to end up insuring most Americans, after the government mandates drove the private competitors out of business. This is precisely the "indirect road" to a single-payer system that candidate Obama said years ago the far left would have to follow to put such a scheme over on an unwilling American public.

And this is precisely what the CBO foresaw when it attached a massive deficit price tag to the president's scheme.