Obama cites fiscal, moral imperatives for healthcare reform

In calling for comprehensive healthcare reform to be enacted by the end of the year, President Obama has set an ambitious goal – one that has eluded Congress for more than 60 years.

Past efforts at reform have been stymied by the complexity of the healthcare system, ideological differences between Republicans and Democrats, and the inability to make trade-offs between containing spiraling healthcare costs and ensuring that every American has access to healthcare.

But at Thursday's White House Forum on Health Reform, Mr. Obama declared "this time is different," saying the economic crisis has turned health reform into an imperative. He attributed the failure of past healthcare reform efforts to "special interests" who had their way over the "public interest."

"This time, the call for reform is coming from the bottom up, from all across the spectrum – from doctors, nurses and patients; unions and businesses; hospitals, healthcare providers and community groups," he said.

"This time, there is no debate about whether all Americans should have quality, affordable healthcare – the only question is, how?" he continued

Advocates of healthcare reform welcome the goal, along with the challenge of reaching a compromise between some Democrats who'd like public healthcare programs expanded to ensure all Americans have coverage and some Republicans who would rather see more people covered by private-sector companies and advocate reforms to the tax code as it applies to healthcare.

Compromise was the goal of bringing opposing factions together at the White House Thursday. But many political and healthcare analysts added a note of caution, pointing out the difficulty of attaining one. They see Obama's goal as a leadership move that is also politically pragmatic.

"If you don't say you want a comprehensive piece in the beginning, you can't move people from one spot to the other," says Robert Blendon, a health policy and political analyst at Harvard's School of Public Health. "But he also has to have some sense of reality that it's been very difficult for the last 60 years to get comprehensive reform done at all, let alone in a very short time period."

Obama insists that health reform has now moved from a "moral imperative" to a "fiscal imperative" that will require people who "strongly disagree" to come together. He also cautioned that there is one option that he will not tolerate.

"The status quo is the one option that is not on the table," he said. "And those who seek to block any reform at any cost will not prevail this time around."