President Obama addressed a rare joint session of Congress Wednesday night on health care reform.

"I am not the first president to take up this cause, but I am determined to be the last," he said of this key domestic policy issue.

In attempting to sell health care reform to those who are already covered by insurance, he stressed the urgency of reforming a system that leaves citizens, including middle class Americans, vulnerable to health crises that insurers won't cover.
"We are the only advanced democracy on earth, the only wealthy nation that allows such hardship for millions of its people. There are now more than 30 million American citizens who cannot get coverage...every day 14,000 Americans lose their coverage. In other words, it can happen to anyone," he said. "The problem that plagues the health care system is not just a problem for the uninsured. Those who do have insurance have never had less security and stability than they do today."

He reiterated priorities for reform measures including eliminating pre-existing condition exclusions and annual or lifetime caps on coverage. He assured that those who are satisfied with their coverage could keep it. "Nothing in this plan requires you to change what you have," he said twice during the address.

The president stressed that Medicare would not be altered for seniors. He took pains to dispel misinformation about health care reform, scare tactics perpetrated by political opponents, such as that it would provide a wholesale government takeover of U.S. health care. He said he was not proposing a radical shift but to "build on what works rather than build an entirely new system from scratch."

He also made the economic case for reform saying that employers are often forced to drop insurance due to costs. "American businesses that compete internationally, like our automakers, are at a huge disadvantage," he said. He added that we already pay for the insured since those who are covered pay about $1,000 yearly to cover the uninsured who use emergency rooms for care.

The speech was met with total partisanship; Democrats applauded while Republicans sat on their hands or worse. When the President refuted the myth that the health care proposals would cover illegal immigrants, a Republican representative yelled, "You lie!" an unusual breach of protocol for such a session.

Nevertheless the president stuck to his guns on including an insurance exchange, with a government-run option to take effect in four years. He estimated that only about five percent of people would choose such a plan and assured that the program be self-subsidized by premiums, although government administration means no overhead or profit imperative for such an operation. He compared the smooth integration of a government health insurance component to the successful way in which U.S. public and private colleges co-exist, providing choice without inhibiting the vibrancy of education.

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