Mr. Obama's speech

Next week, President Obama will reportedly give a speech to a joint session of Congress to rally support for his health care program. Here's what I hope to see in the speech:

• A clear statement of which House or Senate Bill he supports.
• An honest explanation of how the plan will be paid for.
• An honest detailing of what people will have to give up.
  

The last is the most important, but is probably the least likely to be discussed. In his public statements, e.g., his press conference about a month ago that is perhaps best remembered for his remark on the Gates arrest controversy, the president has insisted that nothing will change for those who already have and like their insurance policy. At that press conference, a reporter asked Mr. Obama point blank what people would have to give up, and Obama said something like "not having health care."

But surely things will not be all roses. There are trade offs and we live in a world of scarcity. Something will be lost. If nothing will be lost, then that must be proven. Simply pointing out that none of the bills in question requires people to give up their current health insurance--a common tactic for supporters of Obama's not yet existent plan--is honest, but also disingenuous: nobody in the know argues that there is such a provision. Opponents argue instead that the logical outcome of a plan result in some people losing their current insurance.

It is true that the president's opponents will seize on any admission of giving anything up. However, I suspect that making such an admission is the only way to get any bill passed because it would reassure the "public" (yes, I know that's a slippery word) that the president knows what it (i.e., the public) already knows. Charges that the supporters of the health care bill(s) are trying to pull a fast one will have much less traction. But even if I'm wrong--even if the president needs to deny what I claim to be obvious and it helps rather than hurts the chances at getting the bill passed--I still want him to be honest.

I am a firm believer in a national commitment to universal health care (although I'm not convinced that the public option is necessarily the only way to accomplish that goal), and I want Mr. Obama to succeed. But he has to square with the public. Nothing, except perhaps divine grace, comes without a cost, and health care if done right is worth the cost. But there will be a cost. Something will have to give.

I hope the president will admit it.