Will the policy debate narrow or end?
Barack Obama's task tonight is to set boundaries. These points are up for debate, these are out of bounds. (Shown are people in 1969 watching President Nixon on the TV, from my personal blog.)
There is consensus among the experts on what works in health care. Best practices work. Prevention works. Data works. Market incentives that bend toward saving work.
Insurers agree on this, suppliers agree on this, the biggest buyers of health care all agree on this.
It's this consensus the President must, somehow, turn into laws, and into policy, starting tonight.
George W. Bush did that very successfully early in his term. Those who objected to his Iraq policy were free to speak their minds, but they risked their careers if they said, for instance, they were ashamed the President was from their state.
Partisan boundaries are also set by Presidential speeches. Government is the problem. If you're a Republican, it defines your philosophy. Those who agree with you are on your side, those who might even offer a "yes, but" are on the other.
Another good analog to the President's task tonight is President Nixon's October, 1969 speech on Vietnam (that's the picture at the top), and the speeches by Vice President Agnew that followed. This is about building a governing coalition, defining who is serious and who is not in today's debates and tomorrow's.
What must become out of bounds now? Much of the rhetoric we saw in August. Some of what has been on the Talkbacks to this blog.
President Obama is not a socialist. He's not a communist. He's not Hitler, not Stalin. He doesn't want to kill your grandma, or give your health insurance to illegal aliens.
Unless such statements are ruled out-of-bounds this President can't govern. He will be Jimmy Carter, an accident waiting for history to roll over him.
Many Republicans wish for this, or assume it to be true. If they pay no political price for continuing to sell this idea of the President's illegitimacy, they will win the political war. They will rule not just this next election, but the next generation.
A President must also define those objections that are in-bounds, those things we can talk about and negotiate over.
We know the problem. We spend one dollar of every six on health care, more than any other nation, and our outcomes are worse than anywhere else in the industrial world. The market's growth is one thing. This is a cancer. We either get spending down to international norms or we can't compete.
Democrats have proposed a public option, a form of Medicare you can buy into, as one solution to cutting the inflation of health care costs. We can talk about that. We can talk about alternative mechanisms for cutting costs. But if you don't acknowledge the problem you're not in the discussion. You're out of bounds.
This is what Presidents do. They point in a direction and lead. Success is determined first by whether people follow, and only second by whether it's the right direction.
It's what happens after the speech that counts. Do Republicans continue to play patty-cake with talk of "death panels" and pay no political price? Can the President unite his own party and pass a bill?
Stay tuned.
UPDATE:The speech went much as described above. The President set boundaries for what he considered proper debate, he threw Republicans some bones like catastrophic coverage and tort reform, but he also gave Democrats rhetoric that might let them compromise when that becomes necessary.