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Obama health speech: Enough to push reform through?

The president at last laid out his own plan Wednesday night, leaving room for compromise. But high marks for delivery are no guarantee legislation will clear Congress.

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President Obama delivers a speech on healthcare reform before a joint session of Congress Wednesday night as Vice President Joe Biden and Speaker of the House Nancy Pelosi look on.

Molly Riley/Reuters

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President Obama got high marks for delivery. But now that the big healthcare speech is history, it will take time for its impact – if any – to be felt. Historians note that when President Clinton delivered an address 16 years ago to a joint session of Congress promoting comprehensive health reform, he got great reviews – and no reform.

Mr. Obama did, as promised, lay out his own plan for reform, after standing back for months and allowing congressional committees to take the lead on details. In addition to repeating his goals of slowing the growth of healthcare costs and insuring the uninsured, he placed new emphasis on enhancing "security and stability" for those who already have insurance.

Obama also stressed that he was incorporating ideas from Republicans.

"Now is when we must bring the best ideas of both parties together, and show the American people that we can still do what we were sent here to do," Obama said.

One Republican idea that Obama is open to is malpractice reform. He instructed the secretary of Health and Human Services to launch demonstration projects in individual states to test the idea that changes to the medical malpractice system could bring down healthcare costs. Doctors have long asserted that they must practice "defensive medicine" – ordering tests and procedures that may not be necessary – to protect themselves from lawsuits.

Much of what Obama embraced as "his plan" is already on the table in congressional legislation. Insurers would no longer be allowed to deny coverage to those with preexisting conditions or take away coverage from people who get sick. Annual and lifetime caps on coverage would also be removed.

In return for insurance reform, the industry will have access to millions of new customers who will be able to shop for coverage from a new insurance "exchange," or marketplace. Individuals and families below a certain income threshold will be offered tax credits to help pay for coverage.

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