In his speech on healthcare reform before a joint session of Congress last night, President Obama presented the rationale for reform as well as an outline of a plan he favors, and he also tried to dispel many of the misconceptions that have surfaced regarding the bills that have circulated in Congress.

The outlines of his plan are very similar to the proposal released by Senator Baucus over the weekend, but there were two important differences. One is that he would impose a mandate on employers to provide health insurance to their employees, although there would be exemptions for small businesses. The second is that he would provide a public insurance option among the choices from which individuals and small businesses could choose in insurance exchanges established in each state. In explaining the rationale for a public option, he said his concern was that there be meaningful competition among insurance plans. He cited the example of Alabama, where he said that 90% of the insurance market is controlled by just one company. He downplayed the importance of a public option, however, and said that he would be open to exploring alternatives, such as having a public option only in states where insurance companies were not providing affordable coverage, or using non-profit health insurance cooperatives instead of a government-run plan.

In an effort to garner Republican support, President Obama also said that he was willing to consider medical malpractice liability reforms, an issue that Republicans have repeatedly cited as a way of reducing healthcare costs. It is also an issue that the American Medical Association would like to see addressed, but none of the bills or proposals coming out of Congress so far have addressed this issue.
Toward the closing of his speech, President Obama invoked the words of Senator Edward Kennedy and reminded everyone that Senator Kennedy had a history of working closely with key Republicans, including Senators Hatch, McCain, and Grassley, on healthcare issues. While he made a strong case for healthcare reform, whether President Obama succeeded in swaying any Republicans with his speech last night remains to be seen.