Excellent commentary. Thank you for writing this.

I don't think we need to deny high tech medical care to anyone who needs it, including elderly patients. That's the problem with this whole debate: it's centered on costs when it should be about care for everyone in their times of need. Obama's spirit is in the right place. But the president who signed TARP without fretting about the deficit, who signed his stimulus without fretting about the deficit, who bailed out GM and Chrysler without fretting about the deficit, is giving us a "budget neutral" health care plan that falls short of what the American people deserve.

Mr. Gitlin, I want to tell this to my friends: "Americans pay insurance companies twice as much as they pay doctors." Could you point me to a source for that? It's a powerful piece of data.

"National decency"? WTF is that?

I think you're a little off in this blog. Maybe you wrote it too hastily.

The speech was superb for two audiences: the American people who tuned in, and the Dems.

It was surprisingly partisan, however, in its harshness toward Congressional Republicans. While they certainly deserve it after the orchestrated antics of August and the disgraceful, boorish behavior tonight, it was a declaration of war. Obama raised the stakes by publicly humiliating the Republicans (which I certainly have no problem with), but I expect to see "national decency" get chucked by the wayside from here on out.

Was no one else outraged when Obama triangleated between single payers on the "left" and those who want to abolish Medicare on the right?

I must disagree, Mr. Gitlin. In my view, this was the weakest, most garbled, most abjectly capitulatory speech I've heard from Obama so far. He equated advocacy for single payer (Medicare for All) health financing, supported in multiple polls by 60% of Americans overall, including 60% of physicians (including two former editors of the New England Journal of Medicine), with nutcase right-wing positions held by Rush Limbaugh. And I'm expected to applaud his "spirit"?

This speech may be the first time many doe-eyed supporters of moveon.org, Democracy for America, and the like actually heard how weak the public option in current bills actually is.

In fact, some of us who've been raising hell about the fact that the public option in the House tri-committee and Senate HELP bills will be available to just a tiny fraction of Americans were dumbfounded by Obama's assertion that it would be even weaker. He said the public plan would be available only to people without insurance.

How does that square with the cheery descriptions by Robert Reich and Howard Dean of a public option where "you can keep what you have if you like it, or choose the public option"? Under Obama's description, you can choose the public plan only if you don't "have." Worse, Obama portrayed this weakness as a SELLING POINT.

This speech was emblematic of the disaster Obama and his advisers, abetted by Congress and liberal pundits enamored of his "spirit" but unencumbered by attention to substance, have allowed this effort to become.

I am very reluctantly coming to the conclusion that it's time to torpedo this entire effort and start again immediately (because the urgency is real) with a citizen-powered movement that leads with the recognition of equitable access to health services as a human right.

(a) Possibly I spoke imprecisely, but it's a well-known fact that something like 60% of all medical spending is spent in the last six months of life. A huge portion of this is spent in the absence of directives from the patient to forgo extremely costly life-saving measures.

(b) where did I ever claim to speak for the Democrats? For that matter, where has Todd? He is not an elected or appointed Democratic official, and I would not want to speak on behalf of the Democrats, or have them speak on my behalf. They are a national political party that only tangentially and (very) imperfect reflects my public policy priorities.

Another dishonest attempt to parse away the points at issue here. I would expect nothing less.

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