On Wednesday afternoon, President Barack Obama gave a fiery speech to kick off what he no doubt hopes is the endgame for health care reform—or, as the White House has been calling it, health insurance reform. It was a rather belated recognition that the only way he's going to get anything passed is by rolling the Republicans. Putting aside the issue of partisanship, last week's health care summit demonstrated that there is a huge policy and ideological divide between the Ds and Rs over what to do about the nation's troubled health care system. This gap cannot be bridged by the usual cut-the-difference legislative compromises. It is more of an either/or situation. Obama and the Dems want to remake the private insurance system (still keeping it private), and the Republicans do not. So if the president and the Democrats are serious about what they say, they have no choice but to embrace a DIY approach to the legislation. That is, reconciliation—with no apologies.
Obama did look a bit fed-up. But he has no one to blame but himself. (I'm giving Rahm Emanuel a pass.) Obama has reached a conclusion a year into his presidency that seemed rather obvious to others last spring. Think of all the time the White House wasted negotiating with Republicans, both before and after Sen. Max Baucus, the uninspiring chair of the finance committee, led a painfully slow mark-up of a bill that concluded with not one GOP vote.
"Let's get it done," an impatient-sounding Obama said at the end of his remarks. But though the bills on the Hill are in the hands of Senate Majority Leader Harry Reid and House Speaker Nancy Pelosi, who are counting votes and figuring out how to finesse the reconciliation process, it really is up to Obama to lead the way. He will have to lean on reluctant Democrats—on the right and the left—and serve as The Enforcer for any arrangement reached between Pelosi and Reid on how to proceed. That accord might compel House Democrats to vote for the Senate bill before it is tweaked to their liking via reconciliation, meaning the House Ds will be worrying that that their Senate comrades might pull the rug out from under them by failing to pass those tweaks afterward. Obama will have to be the guarantor.
For months, the president allowed the messy legislative process to dribble along on its own. He refused to take sides on various issues. He declined to state his preferences for assorted provisions. He deferred to the legislators. Now he has to take charge. He is the one he has been waiting for.